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MAY 7 1992
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10675 SW HIGHLAND DRIVE
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CITY OF TIGARD MECHANICAL PERMIT Receipt#_
Permit# _
Deac•fption
Table 3A Mechanical.-.a _ _ OTY PRICE AMT
City of Tigard 1) Permit Fee - -0- -0- 10.00
13125 S.W. Hall Blvd. — _
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Perr.tit - 3.00
639-4175 1) Furnace to 100,000 BTU 6.00
_ incl.ducts&vents
Furnace 100,000 BTU +
2 incl.ductE&vents 7.50
Name of Development ,\ Floor Furnace _ 6.00
incl.vent___
Jib , �. .. Suspended heater,wall heater
Address
Address �'�/` '` _ 4) or floor mounted heater _- 9.00
rex tot - Map No - 5) Vent not incl.in
appliance permit 3.00
Lot Block Subdivision — - -- — ---- ---
Name(or name of business) 6 Repair of heating,refr ig., 6.00
cooling,absorption unit
Mailing Address Phoma y, Boiler or comp to 3 HP
Qwner l�' 7) absorp.unit to 100,000 BTU - 8.00 -
City/State Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
y Name 9) Boiler or pomp 15-30 HP 15.00
_ absorp.unit 112-1 million
Mailing Address - Phone - 10) Boiler or comp to 30-50 HP i 22.50 -
_absorp.unit 1 -1.75 million
Contractor city'state Zip 11) Boiler or comp to'S0 HP 31.50
_ absorp.unit 1,750,000 BTU
State Registration Nn City Bus.Tax No 12) Air handling unl'to 4.50
10,000 CFM
Air handling u,tit
I hereby acknowledge that I have read this application that the information given is 13) 10,000 CFM t 7.50
rorreet,that I am the owner or authorized agent of the owner,that plans submitted are in —— — — —
compliance with State laws,that I am regist-wi with the Slate Builders'Board,that the14 Non portable 4,50
number given is corrpct.(If exempt from State registration please give reason below) ) evaporate cooler
) Vent fan connected 3,00
to a single duct
- ---- ' -- - -- - Ventilation system not
16) included in appliance permit 4.50
17) Hood served by 4.50
mechanical exhaust
Signature(owner or agent) - �a a Domestic type
Describe work `&I' additicn F-1 eitaratlon 1 1 repair f I 18 7 50
incinerator
_
to be done _ residential '•I non-residential I 1 _ Commercial or industrial
Existing use of — 19) type incinerator - —T -30.00
building or properly ^__--_-- _ _ Other i.e.,Noodstove,water
20) heater,sciar,clothes dryers,etc. 4.50
Proposed use c+ --- ---
building or property _ _
21) Gas piping one to four outlets 2.00
Type of fuel- oil I I natural gas 1 1 I.PG [ I electric I I
22) More than 4-per outlet
NOTICE - i SUB-TOTAL
THIS PERMIT BECOMES NULL A;11) \" ` IF WORK OR CON-
STRUCTION
ON STRUCTION AUTHORIZED IS NOT "IMMENCED WITHIN 180 4%SURCHARGE '•
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR —PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER - - -- ---- —-----
WORK IS COMMENCED. TOTAL
Special Conditions
------— ---_ Date issued ��
rae � ew s, a
City of Tigard
INSPECTION REQUEST
f o r
4&4hw.A,—< V a., " (- 1�c
INSPECTION TIME: : PERMIT NO. :
DATE: DATE ISSUED:_._.
OWNERS NAME :
a
Lir-
CONTRAC rOR :--,61r-&e-,-��evts.._._
TEST: Air ❑, Water [� , Visual$1 , Laboratory [,I
RESULT: Approved , Disapproved ❑ , Pending G
SKETCH:
INSPECTOR DATE
COTE . Attach supplemental test dale herst,
I
City of Tigard
INSPECTION
REQUEST
for I
r I
INSPECTION TIME: �' ' PERMIT NO. :
DATE: ") /11,/ `J ' DATE ISSUED : I Z
OWNERS NAME . �f.
ADDRESS: f t� I
CONTRACTOR :
TEST : Air ❑, Water[] , Visual p , Laboratory p
RESULT. Approved , Disapproved ❑ , Pending p I
SKETCH: � I
t
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INSPECTOR DATE
[OTE: Attach supplemental test data berets
I
y
71
7U` CITY OP
BUILDING PERMIT APPLICA MN TIGARD DATE ` 19!_N° 0292
THE UNDERSIGNED HEREBY APPLIES FOR P PERMIT FOR THE WORK HEREIN IN Vi ATED ,- 3101
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFILA1199 S.• rQYVNARPHONE
(�WNEFl 0 wl'.e tin L�t9volopmen ; :.t3 i%,P,'7;a �t,,•!r H.L d1�tvlPtCj J[� °J
d�DDRESSIILGER PHONE
" 4ffl ENGINEER
BLi1LDER ryARCHITECT DESIGNER
STRUCTURE CINEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE []DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB [:]FENCE
❑BOND ❑MOVING: ❑CONDITIONAL UrE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
QCCUPANCY LANG USE ZONE hQ BLDG.TYPE "� FIRE ZONE 3 PLAN CHECK BY I HEAT) "'
2 beth
CC LOAD �- FLOUR LOAD HEIGHT _ NO.STORIESL AREA 1192 VALUF 21 `Z
BUILDING DEPARTMENT SET BACKS FRONT I(D REAR 19 LEFT SIDE G RIGHT SIDE (3
Permi• 113[3.0 -- — — —
Plan Check Lrt THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRArTORS TO HAVE CURRENT CITY BUSINESS
1%State I t3U LICENSE. SEPARATE PERMITS REQUIRED FOR SEWBR, PLI;MBING AND HEATING.
Total
BV fs
APPLICANT OR AGENT '
Approved Receipt No.
--� ADDRESS NON
F�
DATE" INSP. TYPE INSPECTION REMARKS , _ PLUMBING DATE
,t!c- y'7r '� `� Contractor
Permit No, L441-71
Rough-in
7•�l�7 f
Fixture
I7 3'7 aK ---- Final
7f7-1 _ _ HEATING r
Z� IM___��ut�.r✓ GJ /-C _— __ _ Contractor
Permit No. 7
76 _ G or Oiler QX14
Rough-in
Final — —
SEWER pirOF
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain) Final
Sidewalk G �'' ✓-7�`
Curb&Street Final
-- — -- _
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCYFinal
CERI IFICATE OCCUPANCY _—.
3-7e4 Landscaping
Zoning Final
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