12045 SW 95TH AVENUE a• rat aim w
.— 12045 SW 95TH AVENUE
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INSPECTION NOTICE
City of Tigard Br:ilding Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspectior, —
Date Requested /Q - / & _ Time A.M. P.M.
Address / 7 13 rt,`i` S L. 9 A� rermit # 9 0- z i3
Owner_ —_ _ Lot #
Builder
The following Building Code deficiencies are required to h,- corrected:
- —iu.•rr�t—
•
le
or
a
Presented to Approved
Inspector _ _- - L1 Disapproved
Date
CALL FOR REINSPECTION
❑ YE! ❑ NO
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested_1 *-1o0 Time A.M. P.M.
Address ��_"U4'S SGVTJ�7 Permit
Lot
Build, r
The followi B (ding Code deficiencies are required to b corrected:
Presented to _ _ App oved
Inspector �,/ e,�—
-- _ I/7 Disapprov
Date �d f(- �'
CALL FOR REINSPECTIOA'
0 YES LJ NO
ENJFNKW IOl 08
CITY OF TWA RD "\-I-
hl A ISI:!.C A l_
��[Ty —T--WARD I-`E R 111: 1" NEC90-0223
COMMUNITY DEVELOPMENT DEPARTMEW ORMON
13125SWFlail Blvd. PO Box 23.397,Tigard,Oregon 972,"3(bo3)p,9-075
I'SSUED.
SITE. ADDRU),j. ;jW 95'ri-I AVE PARUL- 2SI
SUDDIVISION. . . .. : TONING;
DI-OC,K. . L O'T. . . . . . . . . . . . .
1:LASS OF WORK., » -ALT' FLOOR F*URN. . . . « EVAP
F USI.:, «SF' UNIT HE R S v E N'T, F A 14
0 C CU PA N C Y C',R P,, R3 v E*NI's W/O APPL: VENT sys*rE'IS-.
IE""). . . . .. . 11 1. 1,40TI...[:I-i'3/C011r"RE'SSORS HOODS. . . . . . .
FU I-".L J y P E. ..... .... 0 3 H P'.
./GAS/ 3 1.5 HP. DOIIE-S- INCIN:
IIAX 1NPU*rg100000 BTU 15-30 14". . . . « REPAIR U11II'TS.-
1=IRE D A 11 PI"'R S?. . «N 30 50 1-1 P. . ., . » WOODS'TOVE13). .
G)A S PR V'S S U R E. . . 50+ HP. . . .. « CLO DRYERS.. .
1%10-- (.')F:' UN1T, AIR 11ANDI-ING U 14 0 T 1-4 E R UNITS.,
'
F:1)R N < 1.00K D'FU I (�- 1.0000 (:,J111„ GAS OU'rLE"I'S. - I
>:---J-00I/, F4'TLJ:: > 10000 cfn)t
mark k s- Irl s t a I j. p A 5 1 i.11 e I.,
I'll a c3
Ll fU
Jwiie-r: FEES
DERON SNYDER type anlMlllt by date reept
12045 S. W. 9�5*TH AVENUE F,A y 11 t8- 90 JLH 10/15/90
I'IGARD OR 97223 R M'T' J.8. 00
5 F'(,'T 0. 90
C,ON"rROCTOR NOT ON FILE
P ti a)I e ft
18,. 90 TOI'AL
rhREOUIRE'D INSPECTIONS
is permit is issued subject to the regulations contained in the Gats L i.ri e :rasp
Tigard Municipal Code, State Of Ore. Specialty Codes and all other meeflarlic.%0 Inq;P
applicable laws. All work will be done in accordance With
Final Inspec:tir:rn
aprroyed plans. This permit will expire if work is not started
within 181 days of issuance, or if work is suspended for more ..........
than 188 days.
�Iva-rmi.tter-
.........................................
I sl' led fly
.................
C"all fo,r j.vispectic)II 639-4175
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2
CI TY OF I L`-,APD I PT OF POYMENT PPCE IFIT No... ;9 058 18
C;HECI,,'. AMOUNT t A a.ITO
NAME a SNYDER, DERON V. CASH AMOUNT % Cl.OQ
ADDRESS sw 9,3,ril AVENUE PAYMENT BATE e t0 i5/90
SU Bf)IV I`l ION
TIGAPD, OR 972223- 12045 SW 95TH
1
PURPOSE nF PAYME"hil' AMOUNT PAI D PHWOSE Or FAYMENT AMOUNT PAID
2 T.-6-611-1—DF—'r-R—, 90
10YAL, AMOUNT PATI) 10.
CITY OF TIGARD MECHANICAL PERMIT Receipt
# r�v-�1aS
13125 SW HALL BLVD. Permit#4520:1 5
P. O. BOX 23397 Descrip.ion
TIGARD, OR 97223 ?able 3A Mechanical Code _CITY PRICE AMT
(503)639-4175 1) Permit Fee -C.- -0- 10.00
Name ofDeveloprnerit 2) Supppleplement
al Permit 3.00
' Job Address , Furnace to 100,000 BTU
Address �r _ ���� incl.durts&vents J 6'00 1;.:;{•{,
I c.: i S S-C �- —�
1 TaxLof Map No. 2) Furnace 100,000BTU 1 7.50
Lot Block SubdMabn — incl ducts&vents —
Name(or name of twsinessj Floor Furnace
1. �" 3) incl vent `— - 6.00 —
Ma"Address -- Phoma 4) Susperd,�d heater,wall heater
Owner 1 r SLS or floor mounted heater - 6.00 —
-.UyrstaM Zp Vent not incl.in
_1 d n n ZZ 5) appliance permit 300
Nam_ e(oVname o(business) Repair of heating,retrig.,
6) cooling_absorption unit — — 6.00
Mailing Address Phone 7) Boiler or comp to 3 HP
Occupant 120v 5 w W )
absorp.unit to 100,000 BTU _ 6.00
city/state ---- t3) Boile,of comp to 3 HP-15 HP 11.00
'1 o Z absorp.unit to 500,000 BTU _-
Name Boiler or comp 1 ,-30 HP
g) absh
absorp.unit' -1 million 15'x"
Mailing Address pho„a Boiler or comp to 30-F0 HP' — --
10) absorp.unit 1-1.75 million 22.50
Contractor City/StateBailer or comp to 50 HP �—
bP 11) absorp.unit 1,750,000 BTU 31.50
State Registralion No City Bus Tax No 12 Air handling unit to
10,000 CFM 4.50
—
I hereby ar*nnwlrxlge that I have read this application that Cllr!information handling unit on given is 13) 7.5010,000CFM + 7'
corral,Oat I am the owner or authorized agent of the owner,that plans submitled are in
co pkance with State laws,"Cat 1 am registered with the Slate Eu ldersBoard,that the Non portable
number given is cored.(If exempt from State registration please give reason below) 14) evaporate caole• 4.50
15 Vent Ian connected
to a single duct 3
- ----- Ventilation system:lot
18) included in appliance permit 4'50
Hood served by --
17) 4.511mechanical exhaust
Signature(owner or agent) -- Dae Domestic type A—--
Describe work i 7 addition ❑ alteration K repair ❑ 18) incinerator 7.50
to be done _ residential non-residentibi l 1 Commercial or industrial 30.00
Existing use of } 19) type irdnerator
txfilding or properly Other i.e.,woodstave,water
Proposed use of , 201) Other
solar,clothes dryers,etc. 4.50
building or property SF"�w —
21) Gas piping one to four outlets 2.00
Type of fuel- oil ( I natural gas LPG ❑ electric I I - — -
22) More than 4-per outlet
NOTICE SU13-TOTAL /`Ll
THIS PERMIT BECOMES NULL AND VOID IF WORK OA CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 100 5%SURCHARGE C
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUO-TOTAL '
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER — ----
WORK IS COMMENCED. TOTAL /
Spocial ConditionsDt,'e issued-.- _ _------------_--_--
��� 'S �Lt
it
Address Permit No.
Name of Occupant___ Permit char
Mao, ole
Paid by
Date connected
Type of BuildingI.- pection fee
Service Rate
Paid by4—. //"Date
Contractar- Assessment JC. Ao Paid
Size of connection—