11910 SW SUMMER CREST DRIVE 1910 SW SUMMER CREST DRIVE
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PERMIT TO CONNECT
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jard Sanitary District
PERMIT NO 1067 DAT$
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1'FR511T fS GIVEN TO
OF - —TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUST BE POSTED ON 'rHE DESCRIBED PREMISES UNTIL CON-
NF,,TION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAID $ . .... ........._..........TIGARD SANITARY DISTRICT
By
CONNECTION INSPECTED AND APPROVED
Date Superintendent
Address, .-r,+ ��/��ie _ PermP llo. �U
Name of Occu,,ant _ —� Permit .;harge _
Coanection fee--_
- – --- -- ---- ------ . Paid
Date connected
Type of Building___,__ _.._ --,_-- __ ----- --- Inspection fee
Service HatePaid by Date .1
Contractor_-._—._--- Assessment _. . _ Paid__-
Size of connection
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1.191(1 sw quire r ('mgt Dr. --
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INS►-. "TION NOTICE.
Citi of Tigard Building Department
P.O. Box 23397
"Tigard Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested " Time_ A.M. P.M.
Address //" f ��/``t'• / ermit #
Owner yt �'U X41 LCA 2z N`T�� lot #
Builder --�–�
The following Building Code deficiencies are required to be corrected:
Presented io --
_ _ A Approved
Inspector � — - --- -- ❑ Dlwpproved
Date _
CALL FOR REINSPECTION
YE8 ONO
NECHA
CITY I � RD IIlO4
PERMIT
O. PERMIT
OF PERMIT NO. :: ME892232
ON
COMMUNITY DEVELOPMENT DEPARTMENT E ISSUED: 10/26/89
13125 S.W Hall Blvd.,P.O.Box 23347.Tigard.Oreyon 97223.(503)839-4175 \ F'F NO. 892232
JOB ADDRESS: !1910 SW SUMMER CREST DR
TAX. MAR/L.OT SUB: LT: BY:
LAIJD USE:
LOT SIZE:
.ITEM: NO: NO:
WORK CLASS: ADDITION FURNACE (100K AIR HANDLR (IF)
USE. TYRE: SINGLE FAMILY FURNACE 1001;i, AIR HANDLR 109
CONST.TYPE: FLOOR FURNACE EVAP.COOLER
OCCUP.GRR. : HEATER VENT FAN
VENT VENT.SYSTEM
BLR/C601P 0HP HOOD
NST.STORIE S: BLR/COMP 3-15HP INCINERATOR(DOM
DWELL.UNITS: BLR/COMP 15• 301I17' INCINE:RATOR(COM
FUEL TYPE WOOD BLR/COMP 30-50HP REPAIR UNIT!;
MAX. INPUT BLR/COMP 50+HP OTHER 1
FIRE DMPRS? GAS PIPING OUTLETS
HIGH PRESS?
LUW PRESS'' - ---
REMARKS:
Install Woodstove -- owner to do all
wark.. J
FEES:
W Weiss Daniel PERMIT (14.50
N 11910 SW SUmine'r Crest Dr PLAN REVIEW
a Tigard OR 91223 FIXTURES I
PHONE (503) 620-5417 STATE TAX $.73
OTHER
C
O
N
T 1
R
A
C
t
R TOTAL: $15.23
This permit is Issued subject to the regulations contained in Title 14 RECEIPT_ __NO._
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 clone in accordance with the plans and FINAL
specifications and in compliance with all applicable codes and
ordinances The Issuance of this permit does not waive restrictive
covenants. Contractc,r and subcontractors shall have current city
business tax permits This permit will expire and become null And
void if work is not started within 180 days,or if work Is suspended or
Abandoned for a period of 180 days any time after work has
commenced It shell be the responsibility of the permittee to Assure
all fequired insp ns are requested and approved
ZC
Permitter Signature
Issued By (�Ai I FOW-x CT-I9N-tom-4 75 ---
I
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
CITY OF TIGARD MECHANICAL PERMIT Receipt#13125 SW HALL BLVD. Permit N
P. O. BOX 23397 Desc,iption - -
T I GARD, OR 97223 Table 3A Mechank—I Code CITY PRICE AMI
(503)639-4175 1) Permit Fee -3- -t.l- 10.00
Name of Development 2) Supplemental Permit 3.00
Job ---- _-- )Address Furnace to 100,000 BTU 6.00
I
Address 1 incl.ducts&vents
Tax Lot Map No. 7) Furnace 100,000 BTU + 7.50
Lot aleck srrwivisbn incl.ducts&vents
Nemo(or name of business) 3) Floor Furnace 6.00
r ;, ins,vent
, - -
Maifing Address Phone 4 Suspended heater,wall heater 6.U0
Owner Mailing
(�11 C) ) 11 ,,,V, ►7 ) or flour mounted heater
5� rrJ .CftteSi DR (o"LG' 54
City/State Zip 5) Vent not incl.in 3.00
appliance permit
Name(or name of business) 6) Repair of heating,refr ig., 6.00 _
r..Aoy-N cooling,absorption unit _
Mailing Address Phone 7) Boiler or comp to 3 HP 6.00
Occupant absorp.unit to 100,000 BTU _
City1ctate Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp,unit to 500,000 BTU _
Name — 9) Boiler or comp 15-30 HP 15.00
absorp,unit'/z-1 million
Mailing Address Phone 10) Boiler or comp to 30-50 HP 22.50
_absorp.unit 1-1.75 million
Contractor City/state Zip 11) Boiler or comp to 50 HP 31.50
absorp.unit 1,750,000 BTU
State Registration No. City Bus.Tax No. 17) Air handling unit to 4.50
10,000 CFM
I hereby a-knowledge that I have read this application that the Information given Is 13) Air hanr.jling unit 7.50
correct,that 1 am the owner or authorized agent of the owner,that plans submitted are In 10,000CFM +- --
compliance with State laws,that I a ,registered with the State Builders'Board,that the 14) Non portable 4.50
number giv sn Is correct (If exempt frog.State registration please give reason below). evaporate cooler
-- — 15) Vent fan connected 3.00
to a single duct _
-- ---—— ---- 16) Ventilation systr'.rn not 4.50
included in appli.,._,n permit
1 _ - 17 Hood served' r 4.50
mechanical L...laust
Signature(owner or agent) bate is) Domestic type 7.50
Describe work ❑ addition El alteration ❑ repair ❑ M Incinerator
to be done residential IN non-residential ❑ 19) Commercial or industrial 30.00
Existing use of type incinerator
building or properly _ 20) Other Le,,woodstove,water 4.50
Proposed use of heater.solar,clothes dryers,etc.
building or property_ _ — --__� 21) Cas piping one to four outlets 2.00
Type of fuel- oil ❑ natural gas f_.7 LPG ❑ electric O
22) More than 4-per outlet
NOTICE SUR-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- W
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%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 AFTER --
WORK IS COMMENCED. TOTAL .
Special Conditions__ „_,•_��_____�._
�_ Date issued by __ _