12230 SW 126TH AVENUE ' tl�YiY+'r
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IWAV H19zt Ms Matt --
September 29, 1992 CITY OF TIGARD
OREGON
Steven Lewis
12230 SW 126th Avenue
Tigard, OR 97223
Re: 12230 SW 126th Avenue V Permit # MEC 91-0129
1I
On July 25, 1991 a permit was issued for the above project . As of
this date, there �_J i::.) record of any inspection having been
recorded.
Please advise the Building Division of the status of this project
as soon as possible ..:o that the file may be kept current .
Please note that any permit without activity for over 180 days
becomes void. If you need additional time to complete the project,
please contact th:_s department so an extension can be c.iscussed.
Sincerely,
Robert Thompson
Building Department
Noticeb. rev
6125 SVV He 11 Blvd., Tigard, OR 97223 (503) 639-417-i TDD (503) 684-2772 -- ---
111111111, 11AIIIIIIII
CITYOFT11FARD M."'CHAN I CAL
YOf WARD PERMIT
CrT
COMMUNITY DEVELOPMENT DEPARTMENT Ommm PERMI-r #. . . . . . . . MEC91-0129
13125 SW 1*J1 13tvd. P.O.Bax 23397,Toad,O"gon 97223(603)8394175
--TAIE ISSUED: 07725791 —
SITE ADDRESS. . . 12230 SW 126TH AV PARCEL: 2S104AA-03500
SUBDIVISION. . . . ; BELLWOOD ZONING: R-4. 5
BLOCK.. . . . . . . . . . . LOT. . . . . . . . . . . . . :31
CLASS OF WORK. . :ADD FLOOR FURN. . . . EVAP COOLERS:
TYPE OF' USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP,. . : R3 VENTS w/o nPPL: VENT qYSTEMS:
STORIES. . . . . . . . : BOILERS/COMPRESSORS HOOD:. . . . . . . . :
FULL TYPES------------- 0-3 HP. . . . : 1 DOMES. INCIN:
: /ELE/ 3-15 HP. . . . : COMML. INCIN-
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
FIRE DAMPE'I-S?. . 0 50 HP. . . . WOOD STOVES. . :
GAS PRL-SSURE. . . : 50+ HP. . . . - CLO DRYERS. . :
NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. :
FURN ( 100K PTU: 10000 cfm : GAS OUTLETS. -
FURN ) =100K STU: 10000 cfm :
Remar-ks : iNSTALL AIR CONDITIONER
Owner-: FEES ——————————----.-
GTI-:�E 4iii-4t LEWIS type amount by date r,ecpt
3W 126-o'H AVE PRMT $ 16. 00 J1 11 07/25/91 -
PLCK $ 4. 00 JLH 07/25/91 —
TIGARD OR 97F_73 5PCT $ 0. 80 J L 1.1 07/25/91 --
Phone #: 684-0106
Conti-actor-: ------------------------------
CLIMATE CONTROL HTG & A—C
3315 NW 26TH AVE
PORTLAND OR 972:.0
Phone #: 2.::'3-4392- ♦ 20. 80 TOTAL
Req #. . -. 62196
------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal 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 net started
within 180 days of issuance, 1,r if work is suspended for more
than 180 days.
Pet-mittee Signature :_1AA1C1-1
Issued By :
Call for inspection — 639-417r.5
CITY OF TIGARD RECEIPT OF PAYMENT RECEIPT NO. x9l-215730
GIAECK AMOUNT t 20. 80
NAME : CL.IMATT CONTROL INC CASH AMOUNT 0. 00
ADDRESS : 331t5 NW 26TH AVE PAYMENT DATE i 07/25/9t
SUBDIVISION
PORTLAND, OR 97230-
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUN"r j-,'A I D
16. 00 PLAN CHECK 4. 0121
ST. BUILD PER 0. LAO
12230 SW 1.:6TH AVE
TOTAL. AMOUNT V'All) SO
CITY OF TIGARD MECHANICAL PERMIT Fieceipt #
131.25 SW HALL BLVD. Permit #
P. -O. BOX 23397I/ Description— –
T I GARD, OR 97223 � Table 3A Mechanical Code CITY PRICE _AMT
(503)639-4175 d 1) Permit Fee -0- -0- 10.00
Name of DevoWment rr 2) Supplemental Permit 3.00
Job Address 1 11 Furnace to 100,000 BTU 6.00
Address z L ) �(�� ) I incl.ducts&vents
Tax Lot Map No. 2) Furnace 100,000 BTU + 7 5n
incl,ducts&vents
Lot Block Subdivision
Name(or name of business) 3) Floor Furnace 6.00
S incl.vent
Mailing Address Phone 4) Suspended heater,wall heater 6.00
Owner or floor mounted heater
i�7 I;v 126 U -
Cdttlstate zip 5) Vent not incl.in 3.00
— If II�� I',-)
' D q„7,2 z -� appliance permit
Name(or name of business) 6) Repair of heating,refrig., 6.00
A A cooling,absorption unit
Malting Address Phone 7) Boiler or comp to 3 HP 6.00 / p
Occupant absorp.unit to 100,000 BTU 4r
cdyiStale lip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Name 9) Boiler or comp 15-30 HP 15.00
G 'am
`� i absorp.unit 1/2-1 million _ _-_—
Ar-ling Address Phone 10) Boiler or comp to 30-50 HP 22.50
w k� ,t_ _ absorp.unit 1-1.75 million
Contractor Cd iistate „ zip -7 11 Boiler or comp to 50 HP 31.50
-- P0q-TLA&3V)rG' _. ) absorp.Unit 1,750,000 BTU _
c-/U
State Registration No. City Bus.Tex No. 12) Air handling unit to 4.50
l A
10,000 CFM _
��' Air handling
I hereby ackrx,wittdgr: ti.v 1 have reaA m
this application at tire Adlin4l unit
e information given is 13) it ham CFM + 7.5U
amect,that I on,the owner cr authonzed agent of the owne-,that plans submitted are,in - –
c( -,pliance wdf Stale laws,then!am registered with the State Builders'Board,that the 14) Non portable 4.50
oumber given it,axreri.(If exempt from State registration please give reason below). evaporate cooler
15) Vent fan connected 3.00
- - -- ----- -- - to a single duct _
_ -- -- ---- —- 16) Ventilation system not 4.50
included in appliance permit _
17
) Hood served by
4.50
mechanical exhaust
nature(owner or agent] Date Domestic,type
Describe work ❑ addition Cl alteration repair ❑ 18) incinerator 7.50
to be doral_ residential non-residential O 19) Commercial or industrial 30.00
Existing t, a A type Incinerator
building v'r' ::) __ �_—_.__—_ _ 20) Other i.e.,woodstove,water 4.50
Proposed.us,•P. heater,solar,clothes dryers,el;. --
buildint cr pr iperty _ — 21) Gas piping one to four outlets 2.00
Ty(.0 of hiel oil ❑ ntr-'irAl gds D LPG [1 electric ❑ –�— -
---—--- - -- 22) More than 4-per outlet
NQTICE SUB-TOTAL
TdIS PERMIT BECOMES NULL AND VOID IF WORK OR CON — �— L�A
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 10%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK{5 COMMENCED.
TOTAL ,
Special Conditions
Dale issued by
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Ale
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GACA e-4-,
L�wtS T�nf,�LE
PERMIT TO CONNECTt4
Tigard. Sanitary District
PERMIT N? 1564 DATE ; ..
PERMIT IS GIVEN TO
OF
TO CONNECT A ✓_
TO THE SYSTEM OF TIGARD SANITARY DISTRICTv' A
AT
THIS PERMIT MUST BE POSTED ON -'IE DESCReBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION F CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE .PAID =....................................TIGARD SANITARY DISTRICT
CONNECTION INSPECTFD AND APPROVE,)
Date -- — —nte-
5upatt- ndent
Address 12230 S-w. 12bth ___ ?ermit No. 156+
Permit charge___„_
Owner Mr. & Mrs• Le Mar Dornheeker Connection fee 4W,Dz__-
Paid by Tie Cors _.___.
Type of buildinm Rs4idence Date connected2-21-72
Service rate cx)_per wz � Inspection fee 25•00 __.....-....._
Contractor Date Const. Paid r.yjx L AnAt, Date._-1y=72_,_
Size of connecti.or:_ �_4" Assessment,.__ --Pa i d_
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