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INSPECTION NOTICE
City of Tigard Building Department �
13125 Sp Hall Blvd. Tigard, Oregon 97223 1 �Y' +{'�� �y „
Inspection Line (Rec-o-Phonei: 639•-4175 Business Phones 639-4171 �7t
Inspection:
Footing Plbg. Underalab ?tech. nough-in Appr/5dWlk
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Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer. Framing -Bldg.
Poet/Beam Hoch. Rein Drain Insulation -Plumb.
Plbg. Underfloor )Water Line Gyp. Bd. -Hoch,
Date Requested: Timet —ZK-_AH PH
Address:____��i ° J Permit is 'V-0lej l
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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E`J i Inspector: Dater
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APPROVED DISAPPROVED CAPPROVED SUBJEffC TO ABOVE 1
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_call For Roinap.
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CITYOFTIGARD Y - ID ME C�EPM I C`pL
f:F(hl I l' #1. . . . . . . :
n ME C91 106
COMMUNITY DEVELOPMENT DEPARTMENT moM
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13125 BW FWI Blvd. P.A.Boc 23347,Tip M,Onpon 47223(503)630-4175
7I I t_ h4l)JkLE;u. . . » 1 -,0 SW NON'!fr kE Y LN PARCEL: 2S 1 16AD-121,: 0W,
3UR1}IVISJ.ON.
. . . h�1 Ct-4y ZONT'-IG
1:LASSa OF WORK. . :AI.T FLOOR TURN. . . . E:VAP COOLERS:
TYPE OF USE. :SF UNIT HEATERS. . » VENT FANS.
OCCUPANCY GRC1, . :R3 VE=NTS W/O APIPL: VENT SYSTEMS: �
-+TCIRIES. . . . . . . . s LACEILk_R5/CCM►=RESSt']RS HOODS. .. . . , . . .
i-UE~ml_ 7YF'E S _.___._.._._.__..._ 0-3 HFA. . . . DOMES. INCIN:
i GAS/ / ! -1.5 HP. . . . . COMML. I NC;.I N»
1AX INPUT » PTU 15_.30 H1='. . . . : REPAIR UNITS:
:`IRE E?AMPLRF3 . 30....50 1.11"'. . . , . WOOD;STOVES. . .
i"7AS PRESSURE. . . 50+• HP. . . . : CLO DRYERS , :
"40. OF UNi1-G—•-1___.___.-_ -. (3IR HANDLING UNITS OTHER Ul'4IT5.
,•'URN ( 100K Ea-PLJ: i (- 10000 cf m: GWS OUTLETS. : 1
' 'URN ) =100K LTU: 1 +000 cfm :
tip narks: BASEBOARD E L—E.::I TRIC TO GAS PURNPC':E
iwnr r: _....__..._..._.._..............._...... ._......_ _..._._...._.__..__._.__.._ FEES _....,_._.._..:._._ _._.... ... .
1ARGUE_RITE ROPP type amount by dAte r^er-Pt
16750 -W MONTL=RREY LANE PRINT i, 18. 00 ,JL.H 06/28/91 -
SPCI f, 0. 90 TLH 06/:'8/Cil
I;ING CITY OR 972.24
,hone .I:
10NEER Fl,1E?NA(,E
)615 NF_ PORADWAY
1ORTL OND OR
Ohone #: x:'49 5000, $ 11. 90 TOTAL.
f!. . . 36102
_—- -- REQUIRED INSPECTIONS
-._._.__...._.
nis r,erait is issued subiect to the regulations conta)nea in the F i rra.l Ins;Aec.t i on
ioard Municipal Code, State of Ore. Soeciaity Codes ane all other
"oplicable laws. All work will be done in accordance with
j.pproved plans. This perait will expire if work is not started
,ith)n 188 days of issuance, or of work is suspended for sore __ _._._. -....__.-........�_....____ i
.har 180 days.
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CITY OF TIGARD MECHANICAL PERMIT Receipt#
13125 SW HALL BLVD. Permit #
P. O. BOX 23397 I -- —
IU description
TIGARD, OR 97223 Table 3A Mechanical Code —` CITY PRICE AMT
503 639-4175 �' (01D
r� 1) Permit Fee -0- -0- 10.00
Name of Development
� 2) Supplemental Permit 3.00
Job Address it Furnace to 100,000 BTU
1) incl.ducts&vents 6.00
Address �l � ea>.L�/7J/96'��s'1i/'" L/r�?/C(- -
-
Tax Lot Map No. L11- Furnace 100,000 BTO +
Lot Block Subdivision 2) incl.ducts&vents _ 7_50 .
Na (or name of business) Floor Furnace
`" (SL- j 3) incl.vent _ 6.00 —
�" s
Mailing Addr s PhoneSuspended heater,w-ill heater
Owner - 4) or floor mounted heater 6.00
ChSete zip _ Vent not incl.in
/,,/- (-7 72441 5) appliance permit -_ 3.00 }}
Name(or meotbust ) Repair of heating,refrig.,- �—
6) cooling,absorption unit 6.00
Mailing Address Phone Boiler comp to 3 --� --
Occupant 7) absorp.unit to 100,000
0 BTU 6.00
Citylstate Zip 8) Boiler or comp to 3 HP-15 HP
_absorp.unit to 500,000 BTU 1 1.00
Name l, 9 Boiler or comp 15-30 HP
`1/ j .�����Q� ) absorp.unit 112-1 million 15.00
Mailing Address Pho b Boiler or comp to 30-50 HP
'n/r //1f, e '� _ t 0) absorp.unit 1 -1.75 million 22.50
Contractor Cityrsta Zip1.1 Boiler or comp to 50 HP
, � _) absorp.unit 1,750,000 BTU 31. 0 —�
Stele Registration No, City Bus.Tex No. 12 Air handling unit to
) 10,000 CFM 4.50
C� - r __. ---- __ _
lion
I hereby acknowledge that I have read this application that the info rmationn given is 131 10,000 CFM i-Air handling unit 1.50
correct,that I am the owner or authorized agent of the owner,that plans submitted are in
compliance with state laws,that I am registered with the State Builders'Board,that the r Non portable
number given is correct.(If exempt from State registration please give reason below). 14) evaporate cooler 4.50
Vent fan connected
----- ---------- -----. - 15) to a single duct 3.011
--�-_ --
16) Ventilation system not
included in appliance pe r; I 4.50 _
Hood served by +--
lagl
17) mechanical exhaust 4.50
signatur (owner 9gent) Date Domestic type `— — —
Describe work L3 addition C] alteration I- repair [I18) Incinerator 7.50
to be done residential (Inon-resider aIM [] 1 g) Commercial or industrial 30.00
Existing use of type incinerator -
building or properly 20) Other i.e.,woodstove,water
heater,solar,clothes dryers,etc. 4.50
Proposed use of _ �y-ers_____ _
building or property-___.____ 21) Gas piping one to four outlets ' `2.00
Type of fuel- oil ❑ natural gas LPG I I electric I I --
22) More than 4-per outlet
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- ---- - - SUB-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 1805%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 AV-TER -- ---- - - ----------
WORK IS COMMENCED. TOTAL
Special Conditions
Date issued--- - b
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CITY OF T:IC'ARD RF;C;EIPT OF r,nYWNI' Ri:c,,FIPT NO. ,91 c?1479E,
CNE'CP, raMnlJNr a 18. 90
rdF�l'AF= a c-�ItlI�VF_E_R F=I..IRINAf,.:E:: CASH AMOUNT e7►, rr�
G1T11)h1E��,.�: m '; 1.-� I+1F E?RC1F)1?W�aY PAYMC::NT DATE.,' 06/27/91
"3L1SDIV1(BION
PORTUAND, OR
r PUKPC)f3E"' OF PAYMS N T AMOI 1NT PAID I'�URr"�O E_ OF, rinYME NT 0MOUNT Pf l D
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►W[ C;.tiTN I I.AL FSE: 1 C3. o�D ST.
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16 750 SW M0r47 E✓PW7 _-_Y LAW
TOTAL AMC)UM FSA T D _ - ) 1 S. 90
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