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12020 SW 121ST AVENUE
12020 SW 121ST '.VENUE _ N RAO (`J 3 N O N C N INSPECTION NOTICE City of Tigard Building Department P.O. Bo), 23397 Tigard, Ort gon 97223 Phone: 639-4175 Typo of Inspection ' . Date Requested Time A.M. 'YPM. Address Permit Owner Lot 4 - Builder OLE> The f0iowing Building Code deficiencies are required to be corrected: Presented to �pprovsd Inspector El Disepprovod Date CALL FOR REINSPECTION F-1 YES r-1 NO MECHANICAL CITYOFTIGARD �_ PER 4I T. , CITYC�fTl6.4RD PERMIT q. . . . . . . . NE.C90 00..,4 OOMIMUNITI DEVELOPMEA'T DEPARTMENT oasooN FRIM. PERIIT N. : ME C90 0054 13125 SW Hall BN J. P.O.Box 23397,Tigard,Oregon 97 2ZI A&-* ,p 75 1 l . i _ DATE ISSUED: SITE ADDRESS. . . : 1.2020 SW 1.21ST AV PARCEL: 1S134CD••-03900 SUBDIV13ION. . , „ : L.ERON HEIGHTS NO. 3 '7.ONTNGe R-4.5 BLOCK. . . . . . . . . . _ I...01.. . . . . . . . . . . . . ..69 CLASS OF WORK. . :ALT FLOOR TURN. . . . : EVAP COOLERS: TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . : OCCUPANCY GRP. . :R3 VENTS W./O APPL: VENT 13YSTEMS: STORIES. . . . . . . . : BOILERS/COMPRESSORS 140ODS. . . . . . . : FUEL TYPES-- ------ 0-3 HP. . . . : DOMES. INCINe :/GAS/ 3-15 HF,. . . . : COMML. INCINe MAX INPUT: BTU 15.-30 HP. . . . : REPAIR UNITS: TIRE " 'IMF.'E:RS'?. . : 30-50 HP. . . _ : WOODSTOVES. . : GAS PRESSURE. . . : 50+ HP. . . ., : CLO DRYERS. . : NO. OF' UNITS---- --- - AIP HANDLING UNITS OTHER UNIT'S. e TURN ( 100K NTU: 1 10000 eft: GAS OUTLETS. : FURN )=100K BTU: > 10000 cfm: FEES ADAII SORDOTL type amaunt by date rceept- 1.2020 SW 121ST AVE PAYM $ 16. 80 JLH 03/20/90 PRMT $ 1.6. 00 I.GARD OR 97223 5PCT 0. 80 Phc,rie b: Corit radar a A & B HEATING DIAL ONE ACE HOLDING 14915 SW 72ND I ,.GARD OR 97224 _._...._..____..._._._______...._____....._....._.__._..__..__. ..._.._... F-'have b: 503-684-3355 f$ 16. 80 TO'T'AL_ Req N_ . : 31339 ___.. REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Ficial Inspection ligard Municipal Code, State of Ore. Specialty Lodes 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 189 days of issuance, or if work 15 sLsponded for rc-ir than 180 days. ..............._...... _.___ ...__....._.._..—..._.__....... f�prmitcc�P Signati.iree Call fav inspection 639-4175 CITY OF TIGARD RECEIPT OF PAYMENT REC NO: 00101917 CHECK.: AMOUNT 6'1 .80 NAME: DIAL ONE A & B HEATING CASH AMOUNT .00 ADDRESS: 14915 SW 72ND AVE PAYMENT DATE 05-20-90 1-TOARD, OR 97224 BLOCK; NO/ADDk: 12020 SW I'21ST AVE PURPOSE OF PAYMENT AMOUNT PAID PUPPOSE OF PAYMENT AMOUNT PAll') MECHANICAL PERM (90-0054) ib.00 S'rATE BUILD PERMIT TAX (5. TOTAL AMOUNT PAID CITY OF TIGARD MECHANICAL PERMIT Receipt# Permit Description Tattle 3A Mechanical Code CITY PRICE AMT City of Tigsrd -- --- — 13125 S.W. Hail Blvd. 1) Permit Fee -0- -0- 10.00 P.O Bax 2 ';97 --� "— Tigard, OR 97223 � 5 � 3�C.�� 2) Supplemental Permit 3,00 639-4175 3 c1co Furnace to 100,000 BTU 1)_incl.ducts&vents 6.C3 .cru 2 Furnace 100,000 BTU + 2) incl.ducts&vents 7`'i0 Name or Development Floor Furnace 3) incl.vent 6'00 ,lob Address n -- _- __ Suspended heater,wall heater Address � C1 S(� I s r 't 4) or floor mounted heater — 6 2t.0 Tax Lot Map No _-- Vent not incl.In Lot Bloc, Subdivision 5) appliance permit 3.00 Name(or name of blltmeee) �r(Po 9) Repair of heating,refr ig., Pr-- 54 tzI Z- cooling,absorption unit 8.00 Owner Ma n9 Address PF'one 7) Boiler or comp to 3 HP 600 Ole) A veabsorp.unit to 100,000 BTU city/state zip Boiler or comp to 3 HP-15 HP r A(2 0 0 k 9 7 Z 3 8) absorp.unit to 500,000 BTU 11.00 EN __-- 9) Boiler or comp 15-30 HP 15.00 ,:(3 f-� 4- 4 C absorp.unit 112-1 million Melling Address _T Pttorte �- Boiler or comp to 30-50 HP •w G J'V 3.3 S s— 10) absorp.unit 1 -1.75 million 22.50 Contractor CIfy/Stets Zip 1111 Boiler or comp to 50 HP P�Feghtration No. C? 2 2ityy BU No 12_ _ absorp.unit 1,750,000 BTU 31.50 Stale —-- Air handle unit to — Tex '11 33 Y ) ng 10,000 CFM 4.50 I heroby acknowledge that I have road this application that the information given is 13) Air handling unit 750 I cxxrecl,Out I am the owner or oumorized t of the owner,that 10,000 CFM + agen plans submitted are in complbnce with State Tawe,that 1 am registered with the Stale BuildersBoard,that the Non portable number b oorncl.(M exempt horn 914111LIVwx1radon please give,reason twbwl 14) evaporate Cooler 4.50 " Y0 15) Vent fan connected 3.00 ,� --- - to a single duct Ventilation system not 16) .50 Included In appliance permit 4 Hood served by 17) mechanical exhaust 4.50 Synature(Dubai a spent) Date 1181 Domestic type ---_]Describe work n addition O alteration rApair (] _ incinerator _ 7 to be done 4esidential non-residential ❑_ Commercial or industrial t 9) i Incinerator 30.00 Existing use of _ Y� — building or properly _ S _ Other i.e.,woodstove,water Proposed use of — _L>O) heater,solar,clothes dryers,etc 4.50 building or property_ - 21) Gas piping one to tour outlets 2.00 Type of fuel- oil ❑ nature gas LPG ❑ eltactri- n - - 22) More than 4-per outlet NpTI". — -- � THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- — — — SUB-TOTAL u STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 190 Sqo 4R SURCHARGE ,pv DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25'X,OF SUB-TOTAL ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. TOTAL Special Conditions_^ Date issued by I1 OF I'IUARU MLCHANIGAL YLRMl'1 --- - k.it.y of Tigard I'erMiL II 13125 SW Hall blvd. P-0. Box 23397 Oeeortplfon - Table 3A Meehan"Code QTY PRICE AMT Tigard OR 97223 15.19-4175 1) Permit Fee -0- -0• 10.00 2) Supplemental Permit 3.00 Dthe�Sk 1) Furnace to 100,000 BTO incl. ducts & vents 6.00 2) Furnace 100,000 BTU + - - Name of Development — incl, ducts & vents 7.50 3) Floor Furnace T- AddressJob : incl. vent 6.00 4 Address rax Lot Map o. 4) Suspended heater, wall heater Lot Bloch Subdivision or floor mounted heater 6.00 Name ( or name of business) 5) Vent not incl. in - - , y� ,� r� appliance permit3.00 Malting Address P4pne 6) Repair of heating, raun�it Owner cooling, absorption 6.00 city/state ;P 7) Boiler o; comp to 3HP t E h`�` '•- ��(` __._.. absorp, unit to 100,000 BTU 6.00 Name 8) Boiler or comp to 3HP•15HP C',_ I \ICA t L l -it(' � absorp. unit to 500,000 BTU 11.00 Mailing Address Phone 9) Boiler or comp 15-30 HP ' AI " �� ,.Vt � / -Z's absorp. unit t/2-1 million 15.00 Contractor City/Slate ap 10) Boiler or comp 30-50 HP absorp. unit 1-1.75 million _ 22.50 State Registration No. City Bus. T.x No. 111) Boiler or comp 50 HP absorp. unit 1,750,000 BTU 31.50 _ _ 1 hereby acknowledge that i have read this application that thu Information 12) Air handling unit to given Is correct, that I am the owner or authorlZrhf agent of the ownr , that 10 Ow CFM pinna sutmmed am In compliance with Sta!e laws, that 1 am registered with 4,50 the Sute Builders' Board, that the number given Is correct. (if exempt 13 n from State registration please give reason tklnw)• ) Air handling unit 10,000 CFM + 7.50 r - 1_; C: i� r � •> .-`` , ) � 1't( r ' 14 Nun -- -- - - - portable e_vaporatp cooler _ _ 4.50 15) Vent fan connected to a single duct 3.00 /T-{; �e I , /e7/� %�' - 16) Ventilation system not!__ - Signat,;re (owr119tir agent) Date included in appliance permit 4.50 t _ Describe work 0 addilionQ alteration repair❑ 17) Hood served by mechanical exhaust to be done residential Q non-residential Q 4.50 18) Domestic type Existing us© of - - , incinerator_ _ __ 7.50 bili Idrng or properly �- f t 19) Commercial or industrial — Proposod use of J --/L type incinerator _ _ 30.00 building or property 20) Other i.e., woodslove, water - Type of fuel - of I Q natural gas Q LPGQ electrid'5' heater, solar, clothes dryers, etc. 4.50 NOTICE 21) Gas piping one to four outlets 2.00 THIS PERMIT BECOMES NULL AND VOID IF W04K OR 22) More than 4-per outlet CONSTRU(. TION AUTHORIZED IS NOT COMMENCED WITHIN lilt9•TOTAI 180 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY ___ — _ —_4% SUACHARGE , TIME AFTER WORK IS COMMENCED. PLAN REVIEW 25%OF BUS-TOTAL_ 1 Special Conditions -- TO __.. nAlr, .s r� - c. r � �---• by PERMIT TO CONNECT Tigard. Saniiary District PERMIT N9 1085 DATE _ PERMIT IS GIVEN TO r OFTO CONNECT A TO THE SYSTEM OF TIGARD SANITARY DISTRICT AT THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMIE ES UNTIL CON- NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM- PLETED. PERMIT FEE PAID i.. • ............................TIGARD SANITARY DISTRICT a� �� By --- CONNECTION INSPECTED AND APPROVED Date Superintendent 1 i i i I ,address--t9blc- .5 L"' Permit No. Permit charge Owner_ _ _ Connection fee � a'' Paid by �Ia4-v.CZ Type of Building___ _ Date connected Service Ra`e _ Inspection fee,/� Contractor y�_�_ _ �cQ Paid by Date Size of connection �/ �� Assessment. _ Paid