13665 SW 110TH AVENUE isVocords\mi,;ra(InAlargelsV)ui(ding.doc
CITYOF
TifirARD MECHANICAL
� GI''YOF TT'iARD PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT CortEoou
19125 SW Hall Blvd. P.O.Box 23397,TOM,Jrpon 97223(603)&'W4175 PERMIT #. . . . . . . : MEC92--0246
�- 639--4171 V—�- DATE I SUED: 09/25/9=
L.1'FE ADDRESS. . . a 13665 SW I IOTH AV PARCEL: :'S103DC'•-00400
SUBDIVISION. . . . . FAIRHAVE.N COURT ZONING: R-3. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :3
CLASS OF WORK. . :AL.'T FLOOR TURN. . . . : EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP— R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES. . . , . . . . : LAC,ILERS/COMPRESSORS HOODS. . . . . . . :
FUEL. TYPES--------------.- 0-3 HE-1. . . . : DOMES. INCI N:
:/GAS/ / / 3--.15 HP,. . . . : CUlyllvlL. I NC I N:
MAX INf--,L,T': BTU 15-30 HFI. . . . : REPAIR UNITS:
F I RE DAMPERS?. . : 30--50 H1=I. . . . : WL,ODSTOVES. . :
GAS PRESSURE. . . : 5Ql+ HFI. . . . : CLU DRYERS. . :
IVO. OF UNITS----------- AIR HANDLING UNI i S EITHER UNITS. :
F URN ( 100K BTU: 1 ( - 1001210 cf'm: GAS 001L.EI S. : 1
F URN ) =1001-< BTU: ) 10000 c f m:
kemarks: GAS FURNACE
Owner: -------------- � due, FEES
ANDERSON fj i' type amol_mt by date resp'
13665 SW 110TH PRMT $ 25. 00 ,H 09/25/9: -
/ 5F'CT $ 1. 25 JI' -
TIGARD OR 9723
Phone #:
Contract or a
LL i PIA TE CUNT ROL HT'G & A-C
3315 NW 26TH AVE
i-IORTLAND OR 97210
phone #: 223-4393 $ 26. 2; 'TOTAL
Reg #. . a 62196
-- ------ REUU I REL I NSk'ECT I DNS --This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municifal Code, State of Ore. Specialty Codes and all other
applicable laws. All work 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 160 days.
,,ermittee Signature
I s s u e d D y :
Call for inspection - 6:39--4175
�NSPEcrioN NOTICE
City of Tigard Building Department
23125 SW Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection: f'L -C-C I
Footing Plbg. Undersl+b h h. Rough-in Apprl'Sdwlk
Found. Plbg. Top Out Can Line FINALS
Peet/Beam Struct. San. Sewer Framing -Bldg.
Poet/"eam Hoch. Rain Drain Insulation -Plumb.
Plbg. l)nderfloor Water Line Gyp. Bd. -Nech.
Date Requsnted: �/ �f Time: AM _PM
n!;:11'tlMA: %J In CO� U //���•
Permit 0. C l
Builder:
THE FOLLOWING CORRECTIONS ARE RP.Qf:Tarn-
f. .
-e
_j - ---
Inspector.,__
-Inspector:---- II Dates: r
✓APPROVED __- DISAPPROVED APPROV'6D SUBJECT TO ASpVE
\/ /`� _ �• _Call For Reinsp.
c I TY OP T I GARD .. RECE=IPT nF I-IAYMEN-I* R CE t rl NO. a h2--::'3:2"i
CHECK AMOUNT s 7. 35
NAME a 1:1..1.1`PA-C C"ONTROI. INC CNSH AMOUNT s 4,. 00
NDDRFSSs ,315 'JW 26TH AVE. PAYMENT DATE= s 10102.192
SUBDIVISION a
1 OR'1 -nNU, OR t 7''::,'10-
'URPOSE OF PAVMENT f)MOUNT PA.l.) PURPOSE Oi: PAYMF'NT AMOUNT PnID
iECNANICAl_ F'E:: 7. 00 ST. BUILD FSE=R (A. wr
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nNI)FIRSON MFJ9 -0246
-000W.m ......-.A,ft 1
TDI AL. AMCu.lmrr I>t t n - _ > 7. 35
Y
CITY OF T I CARD RE C.E I Fj't OF C'AYMENl RFCC_T Pl NO. 392-2320211.)
CHF!V, AMOUNT r 1A. 90
NOW C;I...IMATI'= CONTROL. CArII AMUUIV'T 0. 00
ADDRESS a .i315 NW 0.6'f I-i AVE. PAYlylF N'I' DATE e 09/25/92
SUBDIVISION x
1'-101ITLAND, OP 97"--'10—
C,—
7i'10—a
' PURPOSE OF PAYMENT AMOUNT PA I D PURPOSE. OF POYMF NT AMOUNT V"A I C1
N MECHANICAL.. Cl'F — 18. 00 ST. BUILD PER 0. 90
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13665 SW 1 101 H
NOTt- s BALANCE 1)1.!C'= OF 35
TOTAL AMOUNT PAIL) > 18. 90
City of Tigard
13125 SW H,311r,I,1 �. APPL'CATION Permit #
PO Box 23397 x83
Tigard, k.;;,t 97223
(503) 639-4171 T _
%blo 3A Mechnnical Mode OTY PWCE AMT
Job � �� �I(��-�� 11 Permit Foe - 0• �il t0.00
address
I 7) Supplemental Permit
1) incl. ducts&vNnts�+�� 6.00 ID
Yry ..K• —�! 1.•.» ur1-Anaceeffoo,000 tlI V i
Owner �� T`� SILK`' I� 2) incl, ducts& vents 1.50
u,1�w1 aMoor FurnAnco
3) irtcl vont 61,10
•+ • ��• � uspandc+d seater, wa
4) or Boor mounted hoator 6.00
y ,«. en snot 7ZI, I�n __...
Orckipant 5) Appliance permit
r,pair of F6vting, refrig V `
0) noling, absor„tibo unit _ 600
6—Mnr c-ciFPMT i pump,
Q 7) to 5 HP absorp unit to 100K BTU G.UO
—
�Iv� «. k•» Dotter or comp, Fout pump,air sand
D ) - ?Jl ) 3 8) 3 15 FIC Absnrp unit to 500K BTl1 11.00
�- r _..._
,t - �• � — -•—"Bo1e�or co`mp,TH�t pump,ani co� nom`- —
� 9) 15-30 HP Absorp and 5.1 mil H'ru 1500
.r 10. oiler or romp,heat pump,air colt
G y (G ! 10) 3050 HP abcorp unit 1.1.75 mil BTU -� 22.50
•Irl '•, "r'd'3 ..7,!; hit%, •re iFiis upp rcauun,that the � 10791 or cnmP,heat pump, dir CorxT~
,i,rTcjc?,that I Am the owner or Authorized agent t 1) > 50 HP :,bsOrp u• 1 1.75 mil BTU - --_ _ 3 1.50
4ms ,ul-nittod are in compliance with State A,r candling unit to
Alit the Construction Contractor's Board, 1 ` 12) 10,000 Ci M 4 50
;,, I : rc •.:nett (11 exempt from State r.�givtrAtion, f r enc reg unn —
• 13) 10,000 CTM + 7.50
(Jon(sortable
14) evaporate cooler 4.50
ant lan conne;aeci��----I-•.__.�
15) Io a single duct 3 1A)
..r sett soon system mot
16) included in appl ansa permit _— •1.50
r' •,.0+r •.wage . - m Oct SEN. Fy
17) mochanical exhaust 4 59
aac C3`w iii `n'r,v i'�, a< rt on �eratwn lJ-- rApeu Commerc+ r'ai orInd�ar—
to oe done rusiclontial(') nrn-r(ti;idential 1S) type incinerator 30.00
ztsang use o w- Other I e.,w Stove,watpl building or pr<nporty _ 19) hanter,solar, clothes dryers, etc. — 4 50 !
Proposed 1Joe of 20) Oes piping one ro four outlets -� — 200
building or pmpany
21) More than 4-par outlet
Type of fuel cit Q natured ggs �� LPO U electr �� -`-'—
MM Minimum Fee$25.00 SUBTOTAL 1
PFRNIITS BECOMF 11010 IF WORK 08 CONSTRUCTION
AUl-HOr117FD IS NOT ,^,OM"F.IJC D WITHIN 180 DAYS,OR -iV 5114 SURCHARGE
IF CONSTRUCTION OR WORK Ij SUSPGNDED 08
ABANDONED FOR A PERIOD OF 1Et0 DAYS AT ANY TIME PLAN RCVIFW 251".OF SUBTOTAL
AFTFR WORK IS COMMENCED. "`
F - TOTAL
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Special Condtinns --
D.-Ov ieaued
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