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i\records\microflm\targets\building.doc
CITY OF TIGARD BUILDING INSPECTION NOTICE \�
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Footing Susp eilin9 Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. UnderslabRou�^11Q Fireplace
Posti13eam StrUM. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation j�erh
Underflr. Insul. Shear WWaI I Gyp. Bd. Elec
Date Requested: U ( l _Time: AM 1117-,
Address:
Builder. _Permit #:m C<—
THE FOLLOVYNGC iRE TIOUS AAE REQrRvP)
x5-75 w)
Inspector- Date:
Date:
\[ APPROVED DISAPPROVED _APPROVED SUBJECT TO ABOVE
--Gall For Reinsp.
CITY OF TIGARD MECHANICAL
COMMUNITY DEVELOPMENT DEPARTMENT (=,ERM1 T
13125 SW Hall Blvd.Tigard,Oregon 97223*0192 (603)630-4171 PE RMI T #. . . . . . . : MEC95--0 7
63") DATE-_- I:35UCD: 0811017
PARCEL: 1 S 13,3CD--0:200
5 i TE ADDRESS. . ., 136i-::'l SW A S14BURY LN
GUBDIVI6ION. . . . : COTSWAALD MEADOWS ZONINF: R-25
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . ..30
CLASS OF WORK. . :(tLT FLOOR FURN. . . . : EVAP COOLERS
TYPE: OF USE. . . . :SF UN IT HEATERS. . : VENT FANG— :
OCCUPANCY GRP. . :R3 VENTS W/0 APPIL: VENT SYS7 LI4J:
STORIES. . . . . . . . : BOILERS/i3OMPRESSOR5 HOODS. . . . . . . :
I`�*UE:L_ TYF'La ---- -___ __ 0-3 HP. . . . : DOMES. INCIN.
a/GAS/ / / 3-15 HP. . . . : COMML. I NC I N:
11AiX INPUT: BMTU 15-30 HP. . . . : REPCIl:R UNITS :
(~IRE DAMPERS?. . : 30--,150 HP. . . . WOODSTOVES. . :
90S PRESSURE. . . : 50+- 11F'. . . . CLI D"RYCR 3— :
NO. OF UNITS-----.__.--._ AIR HANDLING UNITS OTHER UNIT..
TURN ( 100K DTU: <-- 1121000 c.f m . C:r+ 3 G U T L.E T;:;. : j.
'-*URN ) =100K BTU: > 10000 cfm: ,
Remav-ks :
Owner: -- - - --_.__.__._....._...____._.______.__.._..___._._____._ ----.--..__.._____ ___....___. p-EEc;
_..
TACUUCLYN AGEE type ano,.mt by date r•ecl�l:
13621 SW ASHBURY 5T. F'RMT 6 i 15. 1210 B 03/10/95 95 -C`6�109e,
SF'C T 1 1„ `5 B 03./10 '35 E,'i121')Q1
rIGARD OR 972L3
-Ahnne #:
DEAN sTODDARD
L2803 NE 49TH ST.
VANCDUVER WA 9pc,6
'>hcne 0 : 7,37--9949 ? 26. TOTifl-
Reg *. . : 82299
RE QU1 RED INSFPLC.;T I C)NS __.......,
This persit is issued subject to the regulations contained in the FirialInspect i ur1,
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This perait will expire i( work is not started
within 188 days of issuance, or if work is susperded for more
n2" !R@ days.
P.i-m i t t e e
Call for inspection 639-4175
City of Tiga MECIANICAL PERMIT Planck/Rec. #
13125 %."N 'HaA Elvd. APPLICATION Permit # 1Y1( C 5-DL'1S'
Tigar-j, OR 9-7223
(503) 639-rf'-; 1
ion
Tableble 3A Mechanical Coca OTY PRICE AMT
.iob x �'v ' pG%"�`(�J j 1) Permit Fee -0-
0- 10.00
2) Supplemental Permit 3.00
- " urnare o BTUADI
I 1) incl. ducts 8 vents 6.00
r.. ,
Furnace +
Owner Z 2) incl. ducts 3 vents 7.50
• Floor Furnance
I�4 fi 3) incl. vent 6.00
IrNw. «. uspen heater, wall eater
4) or floor mounted heater 6.00
Occupant N° Verif not incl. in
5) appliance permit 3.00
Repair of heating, reffig.
6) cooling, absorption unit 6.00
r
Boiler or camp, heat pump, it con .
twu
7) to 3 HP; absorp unit to 100K BTU 6.00
•" Boiler or comp, heat pump, air co
Contractor �' 8) 3-15 HP; absorp unit to 500K BTU 11.00
' q of ,r or comp, ea p,pumair con .
�Qf� t� 9) 15-30 HP; absorp unit .5-1 mil BTU 15.00
°' ' off-"if—r or comp, heat pump, air cond.
Z. C 10) 30-50 HP; absorp unit 1-1.75 mil BTU 22.50
ere y ao�ow ge a ave acT�is appuca ion, a e Boiler or comp, eat pump, air cond.
Information giver is correct, that 1 am the owner or authorized 11) >50 HP; absorp unit 1.75 mil BTU 3750
agent of the owner, that plans submitted are in compliance with Air handling unit o
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 450
Board, that the number given is correct. (If exempt from State Air an ing uni
registration please give reason below) 13) 10,000 CTM + 750
on
portable
14) evaporate cooler 4.50
Vent an connected
15) to a single duct 300
Ventilation system no
16) Included in appliance permit 4.50
Hood serve y
17) mechanical exhaust 4.50
Describe wo newrj addition U aeration
repaii-CT CommoirCalor industrial
to be done residential Q non-residential Q 18) type incine,itor 3000
Existing use of Dthis—ri.e,ws oovve, water "- -
building or property - 191 heater, s-)lar, lothes dryers, etc 4.50
Proposed use of 20) Gas piping i four outiets 10
building or property _Y
.4 21) More thar diet (each) 2.00
Type of fuel -oil Q natural gas 1 LPG i 4-p.
Q electric Q
Minimum Fee $25.00 SUBTOTAL L�
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5%SURCHARGE ', Z
IF CONSTRUCTION OR WORK IS SUSPENDED OR - - --
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 23% OF SUBTOTAL
AFTER WORK IS COMMENCED
TOTAL �G 11?
r-+
Special Conditions _
-- _ Date Issued 0 y - by --
rwooalloar*rsa+rr
r I TY OF 'P I CARD - RECEIPT OF PAYMENT RECEIPT NO. :9 Fj--2 69(490
CHECK AMOUNT : 1726. r,�
NAME t DEAN STODDARD CASH AMOUNT 0. 00
ADDRESS t INSTALLATION PAYMENT DATE
t 2803 NE 49TH 91'. SUBDIVISION
VANCOUVER, WA 98682-
PURP013E OF PAYMENT AMOUNT FSA I D PURPOSE'. OF PAYMENT AMOUNT PA I l)
MECHANICAL PE 25. 01A ST. BUILD PFFD 1 . 25
13621 SW ASHBURY ._ MECHANICAL PERMIT Me 0 45'_0 7--7S
TO-f AL AMOUNT PAID -- - -- -> 26. 25