11965 SW MANZANITA COURT 11965 SW MANZANITA COURT
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INSPECTION NOTICE rn
City of Tigard Building Department Cv VI"
P.O. Box 23397
Tigard. Oregon 97223
I ,Phone: 639-4175
�l G�. / A
Type of Inspection /
Data Requested_ c? r ( � . , ms A.M. M.
L Permit
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Address � /
<11 Lot #
Owner
BuilderThe following Building Code deficiencies are required to be corrected:
Presented to KA proved
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Inspector1-1Disapproved
Qm�=
Date ��
CALL OR REINSPECTION
YES 0 NO
ME-ICIA AN I.Al PERMTT
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CITY OF T�GM RD CITY-OrTWAIRD
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DEVELOPMENT NT DEPARTMENT
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13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard.Oregon 97223.(503)639-4115
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MAP/L.01 F50R .
NO: 0.0
WOPK CI A55 : 6j..'J'EP61JDN FURNAEX: <100K ATP VIA
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All*-� 1AANDI.-P 10K
U- Tyl:-"E : SlNGLAIE FIAMILY V"LIPNOCA.. 100X,4
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15W MANIANIA'A CF
(AP 97203 It 44F.I:;
IIIIIIii: TAX
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CANINTY 51'0VI:'
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RECti.TP1 NO
This permit is issued subject to the regulations Contained In Title 14 .....................................
of the TMC, State of Oregon Specialty Codes.Zoning regulations
and all other 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 all applicable codes and
ordinances. The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
business tax permits This permit will expire and become null and Im. J:NAL,
void If work Is not started within 180 days,or it work is Suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
r�mittee Signature
Issued BYr
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
11r i
cl
OF TIGARD pL,'.('filFlT (3F PAYMPTI RE-C 14L.
AMOONT
NAME: '1*R1 COU19TY STDIVE-CHIMNEN CAEH AIVICIUNI
D f)
17,900 S)7TH Cl' DATE 09
RE 5 C�j pj._OCv, W0/AVDP-
TIGARD, OR 97224
sw 11ANIANIlk
ptjp��,Osr-, CjF PA'Y'llEH"r' AMOLINI f"O I b
AMOUN'l PAID
F PAYMU.NT
14.513 BUILD PF-T'M11' Tf'-;Y. ,.3
PERM
fHANK
Tf,")TAL AMOONT' PAN,'
C'
EXPANATIO AMUUNT 1582 98-22/1230
TRI COUNTY STOVE AND CHIMNEY
13900 SW 87T11 GT.
1IGARD,OR. 97224
,IDE(503)289-2123 WESTSIDE(503)684-0691 ---
, LLARS CHECK
TO THE OR DEI OF" OROS', INC, SOC.SE `,- �R AMOUNT
DESC o
U.S.BANK
MOLALLA,OR n`I
/ AUTHORIZED StONATURF
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11'00 L 58 211' 1: 1230002201: 16 ? 0009 610118 60000000 15 2 3"'
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CITY OF TIGARD MECHANICAL PERMIT Receipt# _
Permit#
Description
City of Tigard
Table 3A Mechanical Code _QTY PRICE AMT
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 - --
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 —Furnace to 100,000 BTU
1) incl.ducts&vents 6.00
Furnace 1(),000 BTU 4—
2) incl.ducts&vents 7.50
Name of Development Floor Furnace --
3) incl.vent _ s
Job Address — Suspended heater,wall heater
Address 4) or fluor mounted heater 6.Q0
Tax Lot —i- Map No -` Vent not incl.in
Lot Block Subdivision 5) appliance permit 3.00
Name(or name of business) Repair of heating,refrig.,
Li'7rv2 6) cooling,absorption unit 6.00
ain ddress �1 Phone 7 Boiler or comp to 3 HP
Owner l �.• �/�. ) absorp.unit to 100,000 BTU 6.00 _
City/Stale -Z`ip8) Boiler or comp to 3 HP-15 HP 11.00
_ absorp.unit to 500,130L,t3TU
Nafhe 9) Boiler or comp 15-30 HP
sy >> absorp.unit 112-1 million 15.00
�� .,.fir-.t `;�cP ',�e -- --
Mailing Address n 10) Boiler or comp to 30-50 HP
F absorp.unit 1-1.75 million 22.50
Contractor cityislate Zip 11 Boiler or comp to 50 HP —
Zy , c/7/`� 1, absorp.absorp.unit 1,750,000 BTU - 31.50
State Registration Qo�— City Bus.Tax No. 12) Air handling unit to
- 10,000 CFM 4.50
1 hereby acknowledge that I have read this application that the information given is 13) Air handling unit 7.50
rx)rrect,that I am the owner or authorized agent of the owner,that plans submitted are In 10,000 CFM i
compliance with State laws,that 1 em registered with the State Builders'Board,that the Non portable
number given is correct.(If exempt from State registration please give reason below) t 4) evaporate cooler 4.50
15) Vent tan connected
to a single duct 3.00
- _-- - - Ventilation system not
16) included in appliance permit 4.50
ea Hood served by
d��-_ e - �S 17) mechanical exhaust 4.50
�54hature(owner or agent) Date Domestic type_ - - .
Describe work I l addition n alteration p repair W 18) incinerator 7.50
to be done___resid-ntial L_1 _non-residential C] Commercial or industrial
F:xisting use of �� p L
1�) type incinerator -7►- 30.00
building or properly _ __- 20) Other i.e.,woodstove,water i.�'-
Proposed use of — heater,solar,clothes dryers,etc.
building or property_
21) Gas piping one to four outlets 2.00
Type of fuel- oil l7 natural gas ❑ LPG ❑ electric [_1
i 22) More than 4-per outlet
NOTICE —
SUB-TOTAL
THIS PERMIT BECOME NULL AND VOID IF WORK OR CON -- ----- -----
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5&10 4.SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR APLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER ------- -- -----
WORK IS COMMENCED, TOTAL
Special Conditions
Date issued _by _—_
Address/ 96
/M Permit No. 93i?
Name of Occupant------- Permit charge
Connection fee
Paid 'by
Date connected
Type of Building Inspection fee
Service Rate Paid by
Contractor Assessment _Paid
Size of connection--,.-
1
I
i
PERMIT TO CONNECT
Tigard Sanitary District
PERMIT Nv 938 DATE
PERMIT .IS GIVEN TOOF
TO CONNEC3' A _�__TO]'HE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST HE POSTED ON THE DESCRIBED PREMISES UNTIL,CON-
NE(,'"I'ION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID {........."........................TIGARD SANITARY DISTRICT
i
BY
�.
CONNEC.rION INSPECTED AND APFROVED \Ix
Date