12245 SW SUMMER STREET ■
1245 SW SUMMER STREET
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INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 9-.e23
Photw: 639.4171
Type of Inspection ---
Date Request/ed 2,/ Time— / AM M.
�P.M.
Address _1_��1_� �-�� ��'' xt�[�.'�/�*ermit #__.-zG1�1 —
Orvner_. —1�G�6�' '�'f�' — -- ---- - �.ot #_—_— --
Budder� _ -----
The following Building Code deficiencies are required to be corrected:
_ ► -z_,_g :;00 PM Flo cel n, L4dH Q.
Presented to __--_ Approved
Inspector __—. -- —__.._.— _ Disapproved
Date
CALL FOR REINSPECT rON
ED Y E 8 0 NO
�=-•-Arie�h�n���l Permit
N° 3 8 3 8
Citi ()f I ilj%Ab
r� DATE:L�-L=---�= -
New Installation� Replace ❑ Relocation l_.J Addition ❑ Alteration CJ
HEATING
CONTRACTOR _ OWNER
ADDRESS_ — _ `_ JOP'
PHONE -- APPLICANT----
Host
PPLICANT —Heat Input Rating(BTU per Hour) _ --- Vent Size_ Flue Size_ —
FUEL OIL�J Gi,S [] ELECT ❑ OTHER -----
ITEM NO. FEE — ITEM -- NO. FEE
For Issuance of Permit —_ SEE BELOW Each Air Handling Unit or Duct System 7.50
New-up to & incl. 100,q00 BTU _ 6.00 Commercial Hood System 7.50
New 100,OCO BUT's & over 7.50 Other Equipment - Each � 4.50
Woodburning Stove _ _ 450 1 Tfip Inspection —� 4.50
Wall-Floor-_Suspended _ _ 6.00 Air Condition Compressor - up to& incl.3 H.P. 6.00
Vent System w/Fan 4.50 Air Condition Com_prossor-3.1 to 15.H.P.incl. 11.00
Repair Heat Cooling 6.00
CITY BUSINESS LICENSE REQUIRED BY ALL C'ON'rRACTORS OR SUB-CONTRACTOFIS ! !
PERMIT ISSUANCE 10.00 Common": - --
FEES
SUB OTAL �d
% STATE _ Issued By
25 PLAN CHEM b i 5
TOTAL S,D if I REC. —
Sig ire of Applicant
SEVVEER PER�`�T
fc; f
Unified Sewer-ge Agency .a,
of Washington Countt�y, CITY OF DATE �-i��-'e
OWNER : (a.An.5�, _ PHONE :
OWNER 'S ADDRESS : _( 3 _J-4 l r,-,
TYPE OF INSTALLATION:
BUILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
❑ NEW SINGLE FAMILY ❑ COMMERCIAL
C
EXIST. (PRIOR TO 7-1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS-- DWELLING UklITS
ADDRESS OF STRUCTURE : A awQ---- _
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES , AND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION ,
PLEASE REFER TO THE PERMIT NUMBER . THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR .
FEES:
PERMIT FEE $
CONNECTION CHARGE
SIDE SEWER INST/,LLATION
O T H E R "10e+0,01 360 ISSUcu BY
TOTAL a p
APPLICANT DATE
a.VJ ER PER
ADDRESS OF STRUCTURE -..--
TAX MAP sl - TAX LOT bO SYSTEM
LOT -"_BLOCK OF urit �• -`=--
A VEO BY 0ATE ISSUED BY DATE
0. U . ' S REMARKS I V4 %j