16910 SW MATADOR LANE MEW
16910 SW matador Ln. 1 ��
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INSPECTION NOTICE
City of Tigard Building Department
P.O Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of InspectionDate Requested—,Requested_,! 2 cam/ _ Time& A.M. _P.M.
Add
rl>ss - ZI��//� +/.) `1� !/�i.4 !�I Permit #.-- -_
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Owner Lot
Builder —_ ?)� AL:".-L— c Z-�Ln.
The following Building Code deficiencies are required to 6n corrected:
Presented toZ+Ipproved
Inspector _-4�2 L ❑ Disapproved
Date
CALL FOR REINSPECTION
C) YES ❑ NO
�_ _�---- MECHANICAL PERMIT -
CITY OF T16A RD) PERMIT NO. : ME892138
COMMUNITY DEVELOPMENT DEPARTMENT TF ISSilED: 10/16/89
1 J 125 S W Hall Blvd P 0.Box 23397.Tigard.Oregon 97223.(503)639.4175 {? I M.PMT.140. 892138
JOB ADDRESS: 16910 SW MATADOR LN
TAX MAP/LOT SUB: RING CIll'
LAND USE:
LOT SIZE:
ITEM: NU-. NO.-
WORK
O:WORK CLASS: ALTERATION FURNACE (100K OIR HANDLR '10
USE TYPE: SINGLE FAMILY FURNACE 100K+ AIR HANDL.R 10K
CONST.TYPE: FLOOR FI.IRNACF FVAP.COOLER
OCCUP.GRP. : HEATER VENT FAN
VENT 'VENT.SY91EI1
BLR/COMP' <3HP HOOD
NO.STORIES: BI-R/COMP 3-15HP INCT:'IERATOR(DOM
DWELL.UNITS: BLR/COMP 15--30HP INCINERATOR(COM
FUEL TYPE BLR/COME' 30-50HP REPAIR UNITS
MAX. INPUT PLR/COMP 504-HP OTHER 2
FIRE DMPRS7 13AS PTPING OUTLETS 2
HIGH PRESS?
REMARKS:
Install qas loq fireplace/gas water
heater. Owner to get K.C. approval.
FEES:
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w S':ari Arnold PERMIT $10,0x1
N 16910 sw leatador 1n PLAN REVIEW
r.
q king city or 97224 FIXT'URES $11.,00
(503) STATE TAX $1.0
------. --— - ----- ---- -— --- -- OTHER
G
0 HOLSCHER MICFIAEl
N
r COLUMBIA HEATING
H 21308SW 90TH
A
G tualatin or 97062
U PHONE (503) 692--4320
La REGISTRATION NO. 38026 TOTAL: 1122. 15
I his permit is issuedRECEIPT NO. A-)subject to the regulations contained In Title 14 / J
of the TMC, State of Oregon Specialty Codes,zoning regulations REQUIRED INSPECTIONS
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and GAS LINE
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 FINAL
husiness tax permits This pormit will expire and become null and
void if work is not started within 180 days.or if work Is suspended of
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.
Peimtt.ee Signature
Issued 6y _... -FAL -FOR -1+#5rPEf.T 1[W 639-4175_
SEPARATE PERMITS REQUIRED FOR WORK
OTHER THAN DESCRIBED ABOVE
CITY OF TIGARD MECHANICAL PERMIT Receipt#
13125 SW HALL, BLVD. Permit #P. O. BOX 23397 Description -
T I GARD, OR 97223 Teuie 9A Mechanical rale CITY PRICE AMT
(503)639-4175 1) Permit Fee -0- -0- 10.00
Name of Development
2) Supplemental Permit 3.00
Job Address — I 11 Furnace to 100,000 BTU
Address %G,V,,e ,_r;t( / - ; f j,�� ., incl ducts 8 vents 6.00 —
Furnace 100,000 BTU +
Tax Lot Map No. �
2) incl.ducts R vents 7''0
Lot Block Subdivision —
Narne(or name of business) Floor Furnace 6.00
i' 3) incl.vent
Mailing AtidreM Phe to Suspended heater,wall heater
4) or floor mounted heater - 6.00
Cnyistrite Zip-- Vent not Incl.in
2 � 5) appliance permit 3.00
Name(or name nl business) Repairof heating,refrig.,
6) cooling,absorption unit 6.00
Melling Address� phos Boiler or comp to 3 HP
Occupant ) ' / v 7) absorp.unit to 100,000 BTU 6.00
City/State ZIP Boiler or comp to 3 HP-15 HP
8) absorp.unit to 500,000 BTU 11.00
Name Boiler or comp 15-30 HP
r 9) absorp.unit 1/2-1 million 15.00
Mailing Address ra - 10) Boller or comp to 30-50 HP 22.50
�/3ez absorp.unit 1-1.75 million v- - -
Contractor oityistate Zip 11) Boiler or comp to 50 HP 31.50
AL a f(4. 7` absorp.unit 1,750,000 BTU
State Registration No City Bus.Tax No 12) Air handling unit to 4.50
10,000 CFM
I herAir handling unitby acknowledge that I have read This application that the Information given is 13) 10,000 CFM �- 7.50
correct,that 1 am the owner or sufhorized agent of the owner,that plans submitted are in —
apnptiance with State laws,that I am registered with the State Builders'hoard,that the 14 Non portable
number given is correct.(11 exempt from State registration please give reason below). ) evaporate cooler 4.50
15) Vent fan connected
to a single duct 3.00
- - - -- - Ventilation system not
16) included in appliance permit 4.,c0
,
Hood served by
-- -� 17) mechanical exhaust 4.50
Signah,rla(owner or agent) Dale 18) Domestic type 7.50
Describe work Eladdition ❑ alteration CJ repair Cl incinerator _ -
to-be done residential,_ non-residential ❑ 19) Commercial or industrial 30.00
Existing use of type incinerator---,--,rte---iT,_
building or properly —. Other i.e�waod>! � fes'
e t r 4.50
Proposed use of solar,clothes dryers,etc.-• -
building or property 21) Gas piping one to four outlets 2.00
Type of fuel- oil p natiral gas F) LPG L' electric E
22) More than 4-per outlet
NOTICE V SUIS-TOTAL Uz
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR v 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._._._._ _ by
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