14875 SW 103RD AVENUE-1 UL# UU , "L# UUL-# . L 39
14875 SW .D AVENUE
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INSPECTION NOTICE
C 'v of Ti rd Builoivf Depart t J
F. . Box 7 -<:'-'
�}T leg3997223
Ve: 639 4175 G �d�LJ
ype of Inspection -
----
Date Requested__ Tme _._ A.M..-/Z--P.M
Address 1Y(` :2s /D Permit #--- -------..
Owner—Q� —__— Lot
Builder
The following BuildingConde deficiencies re required to be corrected:
Presented to —` ❑ Approved
Inspector ❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YE! 0 NO
ur- 1 IUAHU MECHAMI SAL PERMIT P,rrr,it --- -
o _.
Oeser"Jon 7
City of Tigard
Table 3A Meclwdoal Cods---- –
OTY PRICE AMT
13125 S.W. Hall Blvd. 1) Permi'Fee -0- -0- 10.00
R0. Bo.,23,307 - - --—
Tigard, OR 97223 2) Supplemen!al Permit 3,00
639-4175
Furnace to 100,000 BTU
1) incl.ducts&vents OGt 4 8.00 t't
Furnaoe 100,000 BTU +
2) incl.ducts&vents 7.50
None or D.vekVTent 3 Floor Fumace - -
incl.vent 6.00
Job Address Suspended heater,wall heater
Address 4) or floor mounted heater 6.00
rax r°r Map No -� 5) Vent not incl.in
l°f Block Subdivisim _ appliance permit _ 3
Nemo(o.Hams or business) 6) Repair of heating,refr ig
cooling,absorption unit _-- 6.00
MaiwnD Phorw ) Boiler or comp to 3 HP
Owner i,/ - r.- ) / 7 absorp,unit to 100,000 BTU 6.00
Cayi able � — ` ZIP ��9 d� Boiler ar comp to 3 HP 15 HF —�
8) absorp.unit to 500,000 BTU 11.110
g) Boiler or comp 15-30 HP — �
absorp.unit 112-1 million_ 1• .00
Phone t 0) Bdler or comp to 30-50 H P
`` absorp.unit 1-1.75 million 2:5o
Contractor ciy/ -- Wier or comp to 50 HP -
11) s unit 1,750,000 BTU 31.50
Aa/wtrrion CRy Sue Tr,r 12) Air harwJWV unit to
10,000CFM
4.50
lereby acknowledge Bel I rev.read ars appk:abon autl ale kMom+laor+given j@13 Alf handling unit
wrecL Bel I am a»ow w or aua�od:6':agent of ale owner,tel pare et#w aim 1n )_10,000 CFM + 7
oornp/rnor'M1n tapas.Wv*%ant 1 am rerlrared with the sloe Buo&-a'eord.VW ars Non portable
numb«gi-an is oomed.(N Barr-+worn 14) evaporate cooler 4.50
15) Vent fen connected
to a al 3.00
- --- Ventftaticu,system not `---
16) ', Auded in applia_n eepermit --- _ 4.50
Hood served b -
0+Mn l a Iq�r,q - /G•'Z 17) mr..=Ica)exhaust �- - 4.50
the 18) Domestiewe
Delcribs wrxk ❑ , Add4itpn ❑ alteration repair [=J �_nwator 7.50
to be done reskldnflal, _non•residen al f 18) Comrnerdalcxindustrial - --
type I
Existing use of incinerator 30.00
_
building of property_ c.e7 / i>'.4.'C cp 20) Other I.e.,woodstove,water
Proposed use of heeler,solar,clothes dryers,etc. 460
building or MapertY - _ -- /Y��t
21) Gas piping one to four outlets 2.00
ryl;vl of foal-- oil ( ) natural on LPG d electric r'0(III 22) More than 4-per outlet
1HIS PERMIT BECOMES NUII AND VOID IF WORK OR CON - -- - SUB-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 S4486SURCHARGE1.
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED GR - -� PLAN REVIEW 21%OF SUBT�TA
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER - -- --
WORK IS C''MMENCED Tc�
Suacisl G:u►dttinns
-- - ---- — - Date issued - Z 7 by r'L '