11865 SW SUMMER CREST DRIVE-1 j
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec,O-PhOne): 639-4175 Business Phone: 639-4171
Inspection: -2,-2, 'i?^LQ�.d�-GT C
Footing Susp. Ceiling SprinK Rough-in AApr/Sdwlk
Founu'anon Plbg. Underslab i M9ch. Rou h Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam dlech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation
Underflr. Insul. Shear Wall Gyp. Bd. -Elect
Date Requested: ( Lv �r S� Time: AM PM
Address:_- It �� -z y1/L1rKP-
Ce% �W� Permit
THE FO OWING CORF,F_GT;ONSrARE REQUIRED:
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Inspecto --` ate:_/ ( �/
APPROVED __DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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FERMI?
CITY OF TIGARD PE RMDATEI TSSUED:• 1 1/02/99 -037
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd,Tigard,OrN�on 97223.8199 (603)839.4171 F•'ARCEL: 1 S 134CD--08500
aITE ADDRE.',:). .. - 111365 5W ':iUMMFR CREST DR
SUBDIVISION. . . . : BURLWOOD NO. 4 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . 35
CLASS OF WORK. . :AL.T FLOOR FURN. . . . : 0 17V(--4P COOLERS: 0 �
TYPE OF USE. . . . :SF UNIT HEATERS. . 0 VENT FANS. . . : 0 A
OCCUPANCY GRF'. . :R,3 VENTS W/O APPi..: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES-------------- 0-3 fir". . . . : 0 DOMES. I MC T.N: 0 �
: /WOD/ r / 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 MF.. . . . : 0 REPAIR UNITS: 0
FIRE» DAMPERS?— : 30-50 HP. . . . : 0 WOODSTOWES. . : 1
GAS PRESSURE. . . : 30+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS----------- AIR HANDLING UNITS GTHER UNITS. : 0
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FURN ( 100K BTUs 0 <= 10000 (-fm - 0 GAS OUTLETS. : 0
FURN )-100K BTU: 0 > 10000 cfm : 0
Remarks : Install pellet stove
Owners -.___-__.__.________.____ ______._----•--____._-_---____-- FEES
EDWARD SADA AND ROSE tvpe amount Iry date recpt
11865 5W SUMMERCREST V1.RMT $ 25. 00 JSD 11/02/95 95-272432
FjPCT $ i. 29 JSD 11/0'.''/95 95-272432
T I GARD OR 97283
Phone #: 590--38483 .
'.Ont i,-Art or: -._____..__.-______.--.•-------_____...
OWNER
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Phone #: 6, 25 'TOTAL
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Rep #. . 000012)1+
-- ----- REQUIRED INSPECTIONS -------
This permit is issued subiect to the rpoulations contained in the Woodstove Inst►
pard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
applicable 'jaws. All work will be done in accordance with
approved plans. This permit will expire if worth is not started
within 1110 days of issuance, or if work is suspended for ea,e
than IA@ days.
Permittee S i g n a t i.I r e :
Y
Call for inspection - 639--4175
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City of Tigard MECHANICAL PERMIT Planck/Pec. #
13125 sw Han Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-,'171 j
escrpbon
f' l C�U Or r�c "f Table Y Mechanical Code OTY PRICE AV[*
Job 1) Permit Fee 0 -0- 10.00 �
Address
2) Supplemental Permit 3.00
^•^•
Furnace" e fo 10 71 -9=
CL 1) incl. ducts &vents 6.00
Owner , 2) incl. ducts &vents r 7.50
Floor urnance
• a(' ,l �� J •.'��1 3) incl vent 6.00
Suspend eater.waifleater -- - �-
�-,41C4 19011 r- r
4, 4) or floor mounted heater 6.00
•« -%-J e7Vont riot incl. in
Occupant ` o. 5) appliance permit 300
• -111K
" Reo Iteating, re n� g
j c 12 22 6) cooling, absorption unit 6.00
of er or comp,"KeaF pump, au con
CA7) to 3 HP; absorp unit to 100K BTU 6.00
••• � Boiler or comp, heat pump, air cond.
Contractor
8) 3-15 HP; absorp un t to 500K BTU 11.00
T, -
Boiler or comp, Eeat pump, air cond.
9) 150-30 H?; absorp unit .5-1 mil BTU 15.00
• """•^°^ ° " Boiler or comp, heat pump, air cond.
10) 3U-50 HP', absorp unit 1-1.75 mil BTU 22.50
hereby ac now ge that I ave read this application, that t eof er or comp,Teat pump, air ccn .
information given is correct, that I am the owner or authorized 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with it an ing unit to
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50
Board. that the number given is correct. (If exempt from State Air handling unit
registration, please give reason below) 13) 10,000 CTM + 7.50
Non portable V
14) evaporate cooler 4 50
ent an conn'ec-Te-F —
15) to a single, duct I 3.00
Ventilation system not
16) included in appliance+. permit 4.50
17') mechamI xhaust 450
escn e'wo new Qj eadillory U n Q repairomme�cial 67Tn, -IT
to be done residential Q non-to' �� 18) type incinerator 30.00
Existing use�T—�'c'p z �1�� 7 r, erg i e,woo dstove-+Nater — -
building or property _y 19) heater, solar, clothes dryers. etc. 450
Proposed use of 20) Gas pinmc, one to four outlets 2.00
building or property --
21) More than 4-per outlet (each) 2.00
Type of fuel -oil 0natural gaa �nc 0 --
Minimum Fee $25.00 SUBT01AL
PERMITS BECOME VOID IF WORK OR. _ -STRUCTION
AUTHORIZED IS NOT COt1IMENCED WITHIN 180 DAYS. OR 5% SURCHARGE
IF CONSTRUCTION OR V1ORK IS SUSPENC ,OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIF.,-' Pi •1 REVIEW 25°/n OF SUBTOTAL
AFTER WORK iS COMMENCED --- ---
TOTAL
Scecial Conditions
Date issued by
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