10975 SW 108TH AVENUE t !!0
10975 SW 108TH AVENUE
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MAEMTP1 NOTICE
City of TiqurxL 61j".`inti DeparLaw nt
13125 SW Hall Alvd. Tl.cirud, orogoo 972:13
Inspectton Line (Rec-O-Phane): 639-11;5 Business Phone: 639-4171,
.nepectiont t fr
Footing Plbg. Underslab ---Mech. Rough-J.Q1 A
ppr/Adwlk
Found. Plbg. Top Out Gas Lina
(. PINAT.t
Pont/Beam Strutt. San. Sewer Framing -Bldg.
4
Poet/Beam Mach. Rain Drain
Insulation _plumb.
Plbg. Underfloor Water Line Gyp. Bd.
-Neth.
Date Requeated: /..���- CI
Addreae:
_ Permit
Builders C
THE FOLLOWING BCTIONS ARE REQUIRED:
= F3:L_ _
Inspector:_,__ i i44:42
_ Datn: zf (�L1L
ROM DISAPPROVED APPROVED [r
�' 9JECT TO ABOVE
Call Por Reinsp.
NELMEJLME ME
M EC H A N.1(—,A L
PLRI'll I
CITY®FTIGARD "':nYOFTWARD PERMIT 6. . . . . . . . M EC9 I—000:3
CGMMUNITY DEVELOPMENT DEPARTMENT D01F. ISSULD: 01/0?/91
13125 BW HWI Blvd. P.O.Box 23397,Tigmd,Oregon grM(6W)'6394176
'EL: IS134AD-03500
A D D R 10 97'..) SW 10 81 -1 AV
A(;1." PULI I-I')r;11, Z0NTNG R 4.
BLnCK.
C"LASS OF WORK. . -ALT FLOOR TURN, 22 EVAP COOLERS:
TY "OTERS. . .- V E H T F A H
r::F.:. OF UHT*T 141H.
C)C C-U P A N C,Y GRP. . »R 3 VE 61TS W/O OPPI-A VENT SYSTEMS:
(4TORIES. . . . . . . . ..
r-.1 0 1,L 1"R S C 0 m P R 1:7 S S a R S HOODS. .. ..
FUEL TY P ES 0--1*3 HI:,. LOMES.
5 -,0 I'l 111.
INC:IN:
/GAS/
MAX INPUT-. LATU l5-30 Hr:',. . . . REPAIR UNITS-
FIRE DAMP't-__RS� . !1 30--50 HP. . . . WOODSTOVE'S.
GAS PRES'.."URE.. . . 50+ 11P. . . . - CL.O DRYE:RS.
1,10. OF' (iIR 1--JANDLING (.)14 TT S 0T14FR UNITS.
FORN < 1001< EITU( : <"- 10000 --FIII: GAS OUTLETS. I
F'URH )ml.00K BTU- 1 > 1.0000 r 'm:
')DDING NEW GAS 1--URNO(J:
Owmar : FEES ........ .........
DOUG SALLY 1:"AULY A-,Y r)o? :A III Q U 111; b Y d,-..i t e
.1.0`37 5 SW :1.0 81, RMT $ jo
51-DC"T $ (41, 98
TIGARD OF-*,' 97221'3 1::,A Y 11 4> RO. 411 j L..H 01./07/`11.
Pl-ic)rie fi:: 639---483/
CiARYIS 11E.01IN(i & "'!TR C"0101:110H
3105-0 SW UNGER
[,C)RNt.'.LI(.JS OR 97113 .............
Vlhone 0: 628-0617 >k 00. 48 rnTM..
Reg N. 59933
RECMIRED INSPECTIONS
This nermit is issued sub'iect to the regulations contained in the Fi)ial 1visr)r2r-t:.Lc)ri
Tigard Municiral Code, State of Ore. Specialty Codes and all other .......... ......
dpolicablr. laws. All work will be done in accordance with ........ .............
approved plans. This vervit will expire if work. is not started
within 180 days of issuance, or if work i suspended for mor?
..............
than 180
........................................... ............
........... ....... .._....w..._.__._._.........._.......... ..........
P e,f,III i A;t,e e S i q ri a t t.t-r c-
14—;s Ltevd 14y, . ........
call fo-r irir.�r)pcticm 639-41715
I`TY OF TTOARD F'TTEIVT OF F"AYMENT --2(03,49
CHFCKAMOUNT 0. 48
N(.i M F- : GARY 's HEATING/AIR C01,41) CASH AMOUNI ii. (K)
'). (K)
DR
ADESS : 3W50 SW UNGER PAYMENT DAIT-.. (.)7,,91
SUDDIVISTON
COR5NELJUS. OR 97117- -
10975 SW 1 i iF3 Ti I AVP
PU,-�POSE OF PAYMENT ANnUNT PAIL) OF' PAYMENT AMOUNT PAID
,)r. FIV IL-D PF-k, o.9-
T(.lTAL AMOUNT F'01 U) In
I�
CITY OF TIGARD MECHANICAL PERMIT Receipt k
13125 SW HALL BLVD. Permit k
P. O. BOX 23397 J Description
TIGARD, OR 97223 7 ti �/ Table 3A Mechanical Code QTY PRICE AMT
(503)639-4175 I 1) Permit Fee -0- -q- 1Q00
_ —— Name of Development - ----
2) Supplemental Permit 3.00
Job Address-, Furnace/ 11 Furnace to 100,000 BTU — — -
Address 5 4t,- I&-7q-77 incl.ducts&vents 6.00
TAX Lot Map No Furnace 100,000 BTIJ + /
lot Biotic S"vasion 2) incl.ducts&vents ` 7.50
Name(or name Of business) f� Floor Furnace�O il(a s �L �UZ 3) incl.vent 6.00 --
Mailing Adarsa Phone 4 Suspended heater,wall heater
�U-/ ��� s �d,-r� ) orfloor motntedheater 6.00
cityrs ate Zip 5 Vent not ind.in
- r/ LI�, b OL> ) appliance permit 300
Name(or named ness) Repair of heating,ref ig.,
6) cooling,absorption knit 6
Maikng aferess Phone! 7 Boiler or comp to 3 HP
Occupant ) absorp.unit to 100,000 BTU 6.00
Cityrstate Zip Boiler or comp to 3 HP-15 HP
8) absorp.unit to 50.000 BTU 11.00
Name , , 9) Boiler or comp 15-30 HP
�,�1.�r���/� absorp.unit 1/2-1 million 15.00
Malin g-Aden.. Phona Boiler or comp to 30-50 HP
` 1050 S �jV�(JAG&R 6��7 10) absorp.unit 1-1.75 million 50
Contractor city/state Boller or romp to 50 HP
0 , e7 7//S 11) absorp.unit 1,750,000 BTU 31.50 --
State Registration No ' City Bus.Tax NoAir handling unit to
�y
1-5
3 �- Z _I L-I- ` 12) 10,000CFM - 4.50 —
1 hemtry adcrx"wtedge that I have road ltr- hlk:ation that the informationinformationgiven is 13) Air handling unit 10,000 CFM + 7.50r"~e that I em the owner or authorized agern,A the nwnc.,that plans submitted are in
rumlhlianc a with stale laws,that I am registeed with the state,nuilders.l3oani.that thet 4 Non portable �— ---
number given is(),trod.(t exenhlt hre
from state registration please give reason be.kww) ) evaporate cooler 4.50
Vent fan connected
15) to a single duct 3.00
Venti cation system not
161) included in appliance permit 4.50
Hood served by
17) mechanical exhaust 4.50
sombire(oeeror or agent) t talc 1 B) Domestic type
Describe work 11 i ddiUun 11 alteration W rrpau I I
incinerator 7.50
to be done resideni`,al W non-residential 11 Commercial or industrial
30.00
Existing use of 19 type incinerator —
building or propel ly— Other i e.,woodstove,water
Proposed use of _�) heater,solar,clothes dryers,etc. 4.50
rupo _
building or property.._ 21) Gas piping one to four outlets 2,00
Type of fuel- oil ; natural gas F7 LPG (A electric I I — -
22) More than 4-per outlet
N 10E
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- SUB-TOTAL
—
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A''ERIOD OF 180 DAYS AT ANY TIME AFTER --
WORK IS COMMENCED. L TOTAL
Special Conditions
Date issued _ by
k
f
w
I
Address Z02 J-4 Permit No.
Permit charge 2� y, �.
Owner _( D �.c� , �7e .,) Connection fee
Paid by
Type of building .L/ �' Date connected
Service rate /� (,� _ Inspection fee ,ts pO
Contractor
Paid by Date
Sira of connection Assessment ;)aid
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BUILDING PERMIT APPLICATION 11TY TIC ARD DATE '._ • 19 9,101
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHk'Nr 3-0484
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER thioar- .,���
LOT NO.—
OWNER 411--1 «i• Jrk7LJ JOB ADDRESS �. -W 128th Age. HOME ADDRESS'..':JiQ
ARCHITECT
BUILDERE.,QCI"� ADDRESf ENGINEER
_ DESIGNER
ST9UCTURE ANEW Q REMODEL ❑ADD_ITION C3 REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
Q RESIDENCE_QCOMM QEDUCAT IONAL QGOV'T QrELIGIOUS PATIO_❑CAR PORTQGARAGF ❑STORAGE LJSLAB ❑FENCE
QBOND ❑MOVING QCONDITIONAL USE QDESIGN REVIEW QCOUNCIL APPROVED QSIGNS
OCCUPANCY_ _LAND USE ZONE BLDG.TYPE FIRE ZONE PLAN CIAECK BY e W HEAT_
- 'J,Istt airiylu family Uwellbng ti/attached gi.i :5 t,edruom Lath
oerscjo 41- 11
aatrar permit '13911 al�Wer conn, $600, aeuor insp. "�Z5• — —
9 &�LQBR _�1QL2R LOAD
40EQa -2n---l9-1ZQBJE5 1 AREA 074 NO BEOROQMS yALu.L_ 38 5713
BUILDING DEPARTMENT SET BACKS__FRONT 2A REAR .�U LEFT SIDE _�_ RIGHT SIDE I
Permit "I.0J — -
DATE INSP. TYPE INSPECTION REMARKS M PLUMBING DATE
Contractor
Permit No. , Z— s-4-7i
- ! I Pp Rv L k Rough•in__ _
Fixture
U1C Final
HEATING
Contractor
' C Permit No.
(I, ' �)h,u., — OR Gas or Oil A--
Rou h in
Final
SEWFR
Final_
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk
curb dr Street Final
_
Approaa
ch
SLOG DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY lFinal
(� Landscaping
CZoning Final