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INSPECTION NOTICE
City of i igard Building Department
P.O. Box 233,17
Tigard, Ores+-n 97223
,, r-/ Phone: 639-4175
Tvpr. a. Inspection S617;& rl1 c���0 !�Go �< GLP �
Date Reque
ste
d 5-17—97 _�- — Time A.M.
Arldress � SS's T ,�21_�Zpl�f _ Permit # 33
Own it—,4 111 f Skt'-- — -- Lot ----
Builder�.----------- —.�.--------
The folio ving Building Code deficiencies are required to be corref ind:
�d-t_#a c> ten _ { c/ or 7u b n, 4# o r
P,esented to _ _ ❑ Appgved
Inspector Isapproved
Date . .1 —��—
CALL FOR REINSPECTION
YES 0 NO
-FNSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requested Tim® A.M. Ae— W'M.
Addr,.,ss C) *-4z 5!�5
Owner Lot
Builder
The following Building Code deficiencies are required to ba corrected:
4)
le!7AL
Iz
Presented to 9'-Approved
Inspector ❑ Dlapproved
Date
CALL FOR REINSPECTION
D YES El NO
Receipt#
CITY OF TIGARD MECHANICAL
(PERMIT
Permit #
Description
Table 3A Mechanical Code QTY PRICE AMT
City of Tigal d 1) Permit Fee -0- -0- 10.00
13125 S.W. Hall Blvd.
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
b3r 1175 1) Furnace to 100,000 BTU 6.00
_incl.ducts&vents _ l .
2) Furnace 100,000 BTU + 7.50
incl.ducts&vents
Name of Development -`---- 3) Floor Furnaco 6.00
incl.vent
Job Address 4) Suspended heater,wall heater 6.00
Address ; / or floor mounted heater -
1'er Lot Map No. Vent not Incl.In
lot Block Subdivision 5) appliance permit _ 3.00
Name(ur name of business) 6) Repair of heating,ref rig., 6.00
cooling,-.bsorption unit
Mailing Address Phone Boller f,:_comp to 3 HP
Owner 7) absor;. unit to 100,000 BTU 6.00
EWState Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Name i--— 9) Boiler or ;omp 15-30�iP 15.00
absorp.unit 1/2-1 million _
Meiling Address Phon 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 Regis inlion No. City Bus.Tax No 12) Air handling unit to 4.50
r? 10,000 0FM
I hereby acknowledge that I have read this application that the Information given Is 13) Air handling unit — 7.50
correct,that I em the owner or out-rorized agent of the owner,that plane submitted are in 10,000 CFM I
compliance with Mate laws,that I am registered with the State Builders'Board,that the 14 Non portable
number given is correct.(If exempt from Slate registration please give reason below) ) 4.50 evaporate cooler _
-- 15) Vent fan connected 3.00
to a single duct
) Ventilation system not
16 included In appliance permit 4 50
I - - -- ---- -- _— -- Hood served by 4.50
-- - --
-� 117) mechanical exhaust
Signature(owner or agent) bate t 8) Domestic type 750
Describe work ❑ addition C1 alteration 1-1 repair ❑ Incinerator --__
to be done — residential ❑ non-residential I_1 !- 19) Commai tial or Industrial 30.00
Existing use of type Incinerator
building or properly 20) Other i.e.,woodstove'water 4.50
Proposed use of
heater,solar,clothes dryers,etc.
building or property _ — 21) Gas piping one to four outlets 2.00
Type of fuel- oil [-I natural gas L7 LPG ( 1 electric 171
22) More than 4-per outlet
N)TICE — - --- -- --
SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%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
Spacial Conditions
- -- Date issued-_- _—.--by 4 ' —