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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection _&yo 0-'4 .S -
Date Requested _- C'- 89 Time—" A.M.—` Q p—P.M,
Address � �S SGc' (20✓u. c""'_____. Permit *
Owner _ T _v Lot # ��
Builder
The following Building Code deficiencier are required to be corrected:
Presented to _ 1
-�� ❑ Approved
Inspector ` _ .._�-� ❑ Disapproved
Date.
CALL FOR REINSPE MON
0 riE• L7 NO
INSPECTION NOTICE
Ci of Tigard Building Dppartment
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Reque.ted Time A.M. P.M.
Address G Permit
Owner Lot
Builder
The following Building Code deficiencies are required to be corrected:
Presented to
F1 Approved
Inspector _w [t�BFsuppr6Ved
V
Date
CALL FOR REINSP-ECTIC'V
VES No
I'Al". PEwmi'r
Aww,m MEX;HANI
CI7YOFTIVA I:"I:_:T:M*1T NO ME 86:1.800
:IrYOFT41FARD
COMMUNITY DEVELOPMENT DEPARTMENT OREGON JATE 155UED: '0/2P/88
13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 117223.(503)639A175 F'R I M. PM'1 .NO. 0011.000
%-JOB ADDIIC:515 : 1134125 SW COPYLUS c'r
TAX MAP/L.0"T BK
I ANI'.) USE :
I T'EM: NO: NO:
WORK C.'I-ASS: AL.'rr--PATION FLJPNACE' 00l< AIR HAWDLP 0.0
USE TY11-4-K. : FAMILY F'URNACE 1.001<4 A114 HANDLR 3.01<
CONST 'TYPE : FLOOP F*ll-JPN0cI:_-.' EViAiP , C',M]OLER
I-1I:'.:ATEP VE*NT FAN
VENT VENT . 5 Y STE M
L3LR/COMr-*' <;514P HIJUD
NO. STORIES : IJLP/COMP 31,"WIP
DWELL .UNITS : BI_R/(.OMP 13----30H1"
1JE.I... TYPE SLA/COMP 30-.50HP W.:.PAv'.rA UN.ITS
MAX . INPUT 81-.14/1COMV, 50+HP OTHE"A I.
1':'33411K DMPRS7
HTUH PRIF'557
I..L)W 1:14-K51"lle
PEMARKS :
WOODSTOVE;.
0 HAHN JOHN & PERMIT $1.0 . 00
W 12425 SW CURYLUS CT I-"LAN PEVIEW
N I- I
E TGANO OR 97P2_1
STATE WAX
DTHEP
0
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0 TO'T'AL., $13.P3
RE("EIIXT NO.
This permit is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes. zoning regulations
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done In accordance with the plans and
specifications and in compliance with all applicable codes and
ordinances The issuance of this permit does not waive restrictive
covenants Cortractur and subcontractors shall have current city
business tax permits This permit will expire and become null and
void itwork s not started within 180 days,or if work Is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall he the responsibility of the permittee to assure
all required inspections are requested and approved
rmitt..e qnAtUr(t
Issued By LAI IFOP 1NSI::'EC'T1ON 635'....Z1175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN D17.SCRIBED ABOVE
C'.1"1P'+OF VGARD MECHANICAL PERMIT Receipt#
Permit#
Description
robin 3A Mechanical Code QTY PRICE AMT
City of Tigard
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 -
Tigard, OR 97223 2) Supplemental Permit 3,00
639-4175 1) Furnace to 100,000 BTU 6.00
incl.ducts&vents__
Furnace 100,000 BTU l
2) Incl.ducts R vents 7.,c
.0
Name of Development Floor Furnace
3) incl.vent 6.U0
Job Address --- 4) Suspended heater,wall heater 8.00
Address or floor mounted heater —
Tax Lot Map No. Vent not incl.In
Lot Block Subdivision 5) appliance permit 3.00 ----
Name(or name of business) 6) Repair of heating,refr ig., 6.00
cooling,absorption unit
Melling Address Phone Boiler or comp to 3 HP
Owner 7) absorp.unit to 100,000 BTU 8.00
City/$late — Zip — Boiler or comp to 3 HP-15 HP
8) absorp,unit to 500,000 BTU 11.00
Name Boiler or comp 15-30 HP
Ii— 9) absorp.unit 112-1 million 15.00
Mailing Address Phone 10) Boiler or comp to 3n•50 HP — 22.50
absorp.unit 1 -1.75 million
Contractor Clty,State zip ) Boiler or comp to 50 HP
11 absorp,unit 1,750,000 BTU 31.50
State Registration No. City Bus.Tax No 12) Air handling unit to 4.50
10,000 CFM
' hereh; acknow:clge [hat I have read this application that the information given is 13) Ali handling unit 7 60 10000 CFM +
correct.that I am the L wner or authorized agent of the owner,that plena submitted are in , ---
compliance with State'awe,that I am registered with the State Builders'Board,that the Non Dortable
number given Is correct."If exempt from State registration lease give reason below). 4.50
g p � p g 4 evaporate cools)
Vent fan connected
15_ to a single duct 3.00
----- ------ --- -- ----_ --_ Ventilatl,,1 system not 16) incluO ed to appliance permit 4.50
Ho.xi served by
r') _mechanical exhaust 4.50
Signature(owner or agent) — -- - _- - -- Date 181 Domestic type -- 7.50 —
Describe work Ci addition C7 alteration f-i repair L1 __ incinerator
to be done _residential U non-residential L 1 Commercial or Industrial
Existing use of 119) type incinerator 30.00 -
building or properly_— --- -- - I 2'') Oester,seism c ethos,water etc. 4.50 1
Proposed use of — — —
building or property --— _ --- 21) Gas piping one to four outlets 2.00
Type of fuel- oil [_1 natural gas Q LPG Ll electric I l - — -
--- 22) More than 4-per outlet
N TI E SUB-TOTAL
THIS PERMIT BECOMES NULL. AND VOID IF WORK OR CON -- --- —
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ _ •1%SURCHAROE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR — PLAN REVIEW 25''%OF SUB-TOTAL --
ABANDONED FOR A PERIOD OF 160 DAYS AT ANY TIME AFTER ---- - ------- -
WORK IS COMMENCED. TOTAL
Special Conditions
Date Issued_- —_—by
INSPECTION NOTICE
City of Tigard Building Department
12,120 S.W. Main St.
Tigaid,Oreqon 97223
Phone. 639-4171
Type of Inspection
Date Requested Time kI A.M. P.M.
Address
J Permit
Owner Lot #-,_-._
Builder
The following Building Code deficiencies are required to he corrected:
AT
Presented to Approved
In.4pecor Disapproved
Date
CALL FOR REINSPECT60N
0 YES 0 No
CITY OF TIGARD Plumbing Permit
Building Department 4
Residential Commercial ❑ No.
New Installation Replace, Lj' Addition Alteratio-i ❑
Licensed 41. i ' Date
Plumber
Owner �_
Address Job Address di-!!.-j A A4,%�
Phone - ',o Applicant
-,------CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS AND SUB-CONTRACTORS
ITEMjN0. FEE TOTAL
ITEM NO. FEE TOTAL
Fixtures-Traps 7.50 Sewer:First 100 9 30.00
Dishwasher
— Disposal 7.50 Each Addit.100 it. 15.00
Garbage 7.50 Elector Pump
7.50 —
Water Heater 7.50 Water:First 100 ft. 20.00
BackfiowPreventer 7.50 Each Addit.200 ft. 15.00
If _11 Rain Drain:First 100ft. -- 30.00
/
Each Addit.2001t. - 15.00
Mobile Home Space 25.00
Other(Specify -—----7
Rain Dra--Single Fam.Dwelling 15.00
PERMIT FEE Comments:
STATE
Issued By:
56
Receipt No. L Appli-ant
IT S gnature
TOTAL
------- For Plumbing Inspection Phone 639-4171
ADDRESS PERMIT NO.
PERMIT CHARGE none
OUNER CONNECTION FEE
PAID BY
T', PE OF BUILDING DATE CONNECTED
SERVICE RATE INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CONNECTION ASSESSMENT PAID