10395 SW HOODVIEW DRIVE-1 1 �1`� Vr 't h�
{ U
Y� ' �
��\,
1
�.'i
■
P� '
'��.
Y
�E• � 1
��:, '
1
.4 •'
'�r
'. �.,��.
1.
..w
F]
`''
i
/,
A '
t
�'
.. �'�.
y
• r
TI•
�'.
'� ,+
•
A
1 1
Y
I
. � , . ,R '
► ...
I
INSPECTION NOTICE
City of Tigard Building DepaIment
P.O. Box 23397
Tigard, Oregon 97223
Phone: 6394175 1
Tvne of Inspection
Date Requested-- ( / 1 ime _ A.M. P.M.
Address 1�-� N_..LZC�j ___ -__ Kimit *__a4l_4?/
Owner —__ Lot #
Builder —
The following Buildirg Code deficiencies are required to h, corrected-.
i.
Presentel to Approved
Inspector H Disapproved
Date
CALL FOR REINSPECTION
p YES NO
W Ati nXiliff fl1 �R
4.1 1 1 UI" I IV1HII,LJ owl AL"AL r r_171IV11 1 Pormlt M
Description
Table 3A Mechanical Code DTV PRICE AMT
City of Tigard 1) Permit Fee -0- -0- 1G.00
13,125 S.W. Hall Blvd.
P.O. Box 233973.00
2) Supplerr�ntal Permit
Tigard, OR 97223 Furnace to 1 00,000 BTU 6.00
639-4175 t) incl.ducts&ve nts
2) Furnace 100,000 BTU ► 7.50 7,5-0
incl.ducts 8-vents
Floor i„•nac, 6.00
--- _ Nmmo of Development 3) incl.vent
--- Suspended heater,wall heater 6.00
Job Address _ a) or fluor mounted heater _
Address 16 39 ► r a T.F� T
Tax Lot Map No. 5) Vent not incl.in 3.00
appliance permit
Lot Block Subdmsion Repair of heating,refr Ig., 600
Name(or name of business) �) cooling,absorption unit
CA ,, AIit C�/`� Ga��..-��� Boiler or comp to 3 HP
Mailing Address Phone 7) 6.00
absorp.unit l0 100,000 BTU _ .
Owner t 3 - .v c e.,, --- 1 t.00
Zip Boiler or comp to 3 HP-15 HP
9)
cityrsiate _ absorp.unit to 500,000 BTU
76(t/1 IL Boiler or comp 15-30 HP 1500
Name 9) absorp.unit 1/2-1 million
i6ell Boiler or cor ip to 30.50 HP 22.50
Mailing Address Phone S0) abso-^.unit 1 -1.75 million_ _
Contractor Boiler or comp to 50 HP 31
.50
cipestate Zip J )�) absorp.unit 1,750,0_00 BTI I
C I AG kAm A S C) ----y L- ,\Ir handling unit to 4.50
State Registration No. City Bus,Tax
No 12) 10 000 CFM
//IV 7 C1 W,d,b Air handling unit 7.50
I hereby acknowledge that I have read this ;trplacabdr, tint the in rnation given Is 13) 10,,Jo CFM 4
owtact,that I em the owner or authorized agent of the owner,that pions sut+mitled are in
oompkanco with Stare laws,thel I art,registered with the State Bullde Board.that the 14) Non portable 4.50
number given's correct (If exempt tram stale reglwation please gala reason below). evaporatb Cooler
15) Vent fan r.onnWed 3,00
to a singlo duct _
16) Ventilation system not 4.W
included in appliance permit
r I1cA served by 4,50
mechanical axhaust
_a went)hxa tctwMr ) _ to 18) D11ristic type 7.50
Incinerator
ascribe work Lladdition O alteration !A repair O -- Cnmrrerclel or industrial
to be done residential N non-residential U 1 g) 30.00
-- type Incinerator
Existing use of Other i.e.,wrxwdstove,water
building or properly_ --- 20) 1.50
--- _ - heater,solar,clothes dryers,etc. ---
Proposed
Proposed use of
building or property._._ ------ — -- 21) Gas piping one to four outlets — ?T00
Type of fuel- oil natural gas G'l LPG f l electric F1 ---- -
_ 22) More than 4-per outlet
NQTIr._F BUB-TOTAL 6 t
THIS PER-1.111 BECOMES NULL AN VOID it WORK OR COT
V"t� BURCtlAN1OB I`�
STRUCTION AUTHOR17EV IS NOT COMMENCED WITHIN 180
DAYS, OR IF CONSTRUC T ION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF BUS-TOTAL
ABANDONED FOR A PERIOD OF 1130 DAYS AT ANY TIME AFTER
TOTAL.
WORK IS COMMFNCED
Special Conditions _ _..._� ----�----..r _.---_��-_
///f/�� ,t/
_. flnlo Igs�ted , .__!._,1.x!_1.�....__ by ...... ...