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CITY OF TIGARD BUILDING INSPECTION DPIISION
24-Hour Inspection Linc: 639-4175 Business Phone: 639-4171
Date Requested: /.;)_3 / A.M. , P.M. MS'T: a
Location: /��2_(K5 � BtTP: G
Tenant: _1 Suite: _131dg: MEC:` �tb
Contractor: J Phone: ` 7 PLM:
O.vnL . Phone: ELC:
ELR:
SIT: _
BUILDING BLDG(con't) PLUMBING MECH ELECTRICAL SITE
Sike Post/13cam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof lJndFl/Slab Rough-In Ceiling Water Line
Slab Framing 'Cop(hit Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Ilood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C IJG Slab
Shear/Shernth Fire Spklr/Alm Crawl/I'ound Ir I lent Ntun Low Volt
approved Approved Approved Appioved Approved
Appr/Sdwlk Not Approved Not Approved roved Not Approved Not Approved
FINAL FINALAL FINAL FINAL
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M Call liar rein,;pc D Reinspection fee of Srequired before next inspection C1linable to inspect
Inspector: _mac- -__-__ _--_ _-- Date:_ `/ d Page of
CITY CSF TIGARD � . „�
DEVELOPMENT SERVICES
13125 SW Hall Blvd.,7798rd,OR 97223 (503)6394171 "171T17
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CITY OF TIGARD Mechanical Permit Application Recd By. r
13125 Silt HALL BLVD. Commercial and Residential Date Recd - i D-��
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, x304 Date to DnS/T�
Print or Type Permit#L IFC 'T�Q
Incomplete or illegible applications will not be accepted Called
Name of Devoroprneniiftopt ascription
Table 1A Mechanical Code QTY PRICE AMT
Job street Addma. SUNMr A) Permit Feb --o_--- -0- 10.00
Addnss
amp city/state tip B) Supplemental Permit 3.00
Nepro(a"ams of burinese) 1.) Furnace to 100,000 OTU 6.00
Owner L, Lwi I e t,S incl.duds&vents
V `,�O / 2.) Furnace 100,000 BTU+ 7.50
incl.duds&vents
's ZIP Phare 3.) Floor Furnace 6.00
tY o�U7 y(' 3CY1/ incl.vent _
Nome or nn ) 4.) Suspended heater,wall heater 6.00
C rje l rO or floor mounted heater
Occupant ^ 5.) aent not fianuepermsncl.in 3.00
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rty� ' Zip » 6.) 3oiler or comp,heat pump,air Gond. 6.00
f `d [' to 3 HP;absorp unit to 100K BTU
�. 7.) Boiler or romp,heat pump,air Gond. 11.00
7Cl I 3-15 HP;absorp unit to 500K BTU
Contractor MaftCA�su < . 8.) Boiler or comp,twat pump,air Gond. 15.00
� J \ 15-30 HP;absorp un4.5-1 mil BTU
Attach copy of Cityr'itale _ yP Ptrrxme 9.) Boiler or comp,heat pump,air Bond. 22.50
Current Lioer,ses 0 1P ; a�f ig .r � 30-50 HP;absorp unit 1-1.75 mil BTU _
.�,gnst.Cor�. u¢s Up Dde 10.) Boiler or comp,heat pump,air cond. 37.50
>50 HP;absorp unit 1.75 mil BTU
1
COT BushseTex ardwo• Exp.Das 1 Air handling unit 4.50
10,0N)3 CFM
Architect Name 12) Air handling and _ 7.50
10,000 CTM+
Or Ma"Address 13.) Non portabls 4.50
evaporate cooler
Engineer cnyrState --h 1 Phare` 14.) Vent fan connected 3.00
_ to a singles dud _
Describe work New J Addition O Alteration O Repair O 15.) VentiL•ition system not 4,50
to be done Residential O Non-makiential O included in appliance permit
Additional Descnphon of work 16) Hood served by -�-�
mechanical exhaust 4.50
17) Domestic incinerators 7.50
Foisting use of 18.) Commercial or industrial 30,00
building or property_ .. type incinerator
19.) Clothes dryers,etc. 4.50
i Proposed use of r i 20) Other units 450
huildmo or property
n Type of fuel-oil O natural gas O LPG O electric O 21) Gas piping one to four outlets 2.00
I hereby adkw4iedge that I have read this application,that the 22) More than 4-per outlet (each) .50
inforrnat0m given is caned,that I am the owner or authorized agent of _
the owrwr,that plans submitted are in compliance with Oregon State QTY.SUBTOTAL 000A
laws.
Signature of O►mwfAgent Date 'SUBTOTAL
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/�Gt+/ 5%SURCHARGE
PLAN REVIEW 26%OF SUBTOTAL ,
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�,c� f 1 L ! E f l'lI�% Y��� � -- _ TOTAL
Mmiodipvtdoc 'Minimum permit fee is$25+5%surcharge j
ilry 7A8