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1NSPECPIO1 NOTICE
City of Tigard Building Departowent
13125 SR Hall Blvd. Tigard, Oregon 97223 c
Inspection Line (Rec-O-Phone): 639-4175 Buo iness Phone: 634-4171
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Inspections_
j rootinq Plbg. Underslab Koch. Rough-in Appr/Sdwlk
round. Plbg. Top Out Cas Line lINALs
Poet/Beam ,trurt. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Nater Line Gyp. Bd. -NeoA.
Date Requested: �7- L Q ' I�^L�I Tiinees
O1IE (�
Address 1 �Q(CJ ak. !2A—V U-'I, �4��_y1P.06it art -l3`
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Builders 0. C� ' �� 1 p 3
TBE FOLLOWING COMCTIOBS ARE REQUIREDt
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Inspector:_ _ l� 1s4 5
Dates �' � �
1►PPROVRO DISAPPROVRD APPROVRD SUBJECT To ABM
Call For Reinsp.
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F CITY OF TIGARD ��((
'i COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Man lWd.Tigard.Or@W 97223941N ($W)6394171
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pr`d Mu1iCipi) Loot', State of Jre. 5p@Cidlty codfs and @:i J4•e;' -� .a ...__ ..__.._...
.sbif )AWS, Ali !v+.irk wrl', df bane to dCf•ajd,,lrCe *c tM
• plans, ;his per/it ilii rsp;:re i` work is not s:uwtP
ift dAys of 155udiN'@� Of' i` Ni1tlt is SusotndeO
on .,M days.
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City 01"Tfgard MECHANICAL PERMIT PiancWRec. #
13125 SW Hall Blvd. APPLICATION Permit# (11 < - )1
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Tigard, OR 97223
(503) 639-4171
40 � ' esaipUon �
1 T able 3A Mechanical Coda QTY PRICE AMT M
AdJob dr@SS r. W,Su m t `-'k"6 1) Permit Fee JJ -0- 10.00 I
• of�. q,a,� 2) SupPlement3l Permit 3 '
— Furnace to 100.000 BTU
Lm a(- _ 1) ind.duds 6 vents 6.00
kuwm «• � n ' umaoe 100,,000 BTU
Owner2) incl.duds a vents 7.50
c4pasmn umance
3) incl.vent 6.00
+ b.L-q - &jspanded heater.wall heater
4) or floor mounted heater 6.00
»• Vent notincT in
Occupant 5) appliance permit 3.00
w flepair of 1eatnq,rB tig.
6) cooling,absorption unit 6.00
l3oiler or comp,heat pump,aN c0 .
7) to 3 HP absorp unit to 100K BTU 6.00
'Um «� i er or trxnp, at pump,au
Contractor �- Q_ 3-Sf 3 e) 3-15 HP atxorp unit to sooK BTU 11.00
.w i or or comp, at pump,air co .
F U of s. �•�—7JL 1 l 9) 15-30 HP absorp unit.5-1 mil BTU 15.00 `
.r. Boiler or comp. at pump,au .
a0 �.3 S4 10) 30 50 HP absorp unit 1-1.75 and BTU 22.50
TlWt-eFy acknowlecige that I have read is application.that the Boiler or comp, haat pump,air cond.
Information given is correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU - 31.50 1
of the owne(,that plans submitted are in compliance with State Air handling unit to 11
taws,that I am registered with the Construction Contractors Board, 12) 10,000 CFM 1 4.50 4.
that the number given is correct. (if exempt from State iegistration• Air handling unit
please give reason below.) 13) 10,000 CTM f 7.50
- on Porgy -..
14) evaporate cooler 4.50
Vent Ian con
15) to a single dud 3.00
-Ventilation system not - ---
16) included in appliance permit 4.50 -�
SO— Hood i5i;W iy
17) mechanical exhaust 4.50
Describe w new addition alteration repair omma or istna7! t to be done residential 0— non residential Q 18) type incinerator 31.00
Existing use of Other i.e.,woodstavo.water
building or property _^ _ 19) heater,solar,clothes dryers,etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.10
building or property - — —
T of heel-oil �'-- 21) More than 4-per outlet
Type Q natural gas n LPG O electric Q
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Minimum Fee=25.00 SUBTOTAL
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR S%SURCHARGE j
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FON A PERIOD OF 180(JAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL
Special Conditions__ f
_ Date issued by
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