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12285 SW 116TH AVENUE ADDEVS: swA � C �n r F- J 17Vrcordslmi, -oilm\largc(s\building.doc w J 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 n. J .r CD W 7 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 P T V T 7, r G. 0 T . .. . . . . . -nl T M.-ITIR r-*tJPN n F j�'i F. r7 VENT F(INS. . CUPPINCY Gf7r. R VCS 11EN T CYSTCII`�, "OR I Es. 17, 11/1. ly,F RF 9 OR S HOODS. . . . . . . Hr,% . . . . )X I NPIl.!T s ft BTU "RE 7q-1,50 HP. 0 WDIDDSTOU-,.-S. C MO P RYE .,TP '-IONTII� TNO 11NI,-r S OF UN PTHP (1 171 r-Ti IRN � =JOOV, R T'l-1 171 1 000'��, frr, - 0 t y po Cl t U dat e C, t r-4 oyv Aff (tj Plan Chea: _ 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 y J 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 �1�r� /�Gt+/ 5%SURCHARGE PLAN REVIEW 26%OF SUBTOTAL , L �,c� f 1 L ! E f l'lI�% Y��� � -- _ TOTAL Mmiodipvtdoc 'Minimum permit fee is$25+5%surcharge j ilry 7A8