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INSPECTION NOTICE
n� City of Tigard Building Department
J� P.O. Box 23397
J Tigard, Oregon 97223
Phone 639-4175
Type of Inspection
Date Requested �_ _'��� Time
Address 1-�D Permit 4! 2� _—
Owner a - -�,4GDrt�
Lot #
Builder
The following Building Code deficiencies are required to be corrected:
ev
_" �/��J'" rte!—" •'-��/4' /�.l ___ ._� —
Presented to / Appr,)ved
Insnector _ , ,,
- El Disapproved
[late
CALL FOR REINSPECTION
El YES 0 NO
=NUILN-R =—m s v .err
CITY OF TIGARD MECHANICAL . PERMIT Receipt # ) . r
Permit#_ 1
Description
City of Tigard
Table 3A Mechanical Code QTY PRICE AMT
-- ---- -__--`- _-- ---
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 ---
Tiaard, OR 97223 2) Supplemental Permit 3.00
639.4175 Furnace to 100,000 BTU
1) incl.ducts&vents 6.00
Furnace 100,000 BTU +
2) incl.ducts&vents 7.50
Name of Development Floor Furnace
3) incl.vent 6.00
Job Address ,, Suspended heater,wall heater
Address ] S }j� 4- ft c 4) or floor mounted heater 6.00
.C.J , l'1,J
Tax Lot Map No. �' 5) Vent not incl.in 3.00
Lot Bock Subdivision appliance permit
Name( or nim o bualnesa►�� , f 6) cool nig,absorptir of on unit 6.00
Mailing Address Phone Boiler or comp to 3 HP
Owner 7) absorp.unit to 100,000 BTU 8.00
City/State — 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
9) absorp.unit 112-1 million 15.00
Malling Address _ Phone Boiler or comp to 30-50 HP
3"750
7U t ` 6^ q 10) absorp.unit 1-1.75 million 22.50
Contractor CIty/Stme (, Z; Boiler or comp to 50 HP
p 11) absorp.unit 17 50,000 BTU 31.50
State Registration No. City Bus.Tax No Air handling unit to
// / 12) 10,000 CFM 4.5('
I hereby acknowledge that I havd read this application that the Information given is 13) Air handling unit 7.50
correct,that I am the owner or authorized agent of the owner,that plans submitted are in 10,000 CFM +
compliance with State laws,that I am registered with the State Builders'Board.that the Non portable
number given is correct (11 exempt from State registration please gla reason below). 4) evaporate cooler 4'50
Vent fan connected
- - ---- --.._----.-__-- 15) to a single duct 3.00
- — Ventilation system not
-' 18) included in appliance permit 4.50
� Hood served by
x I �. "? 17) mechanical exhaust
4.50
SlgnatOre(owner or agent) `'' i bate Domestic type
Des&ibe work I_I addition f 1 alteration F1 repair r! 18) incinerator 7.50
to be done residential [tl- non-residential ❑ Commercial or industrial
_ — - 19) 30.00
Existing use of type incinerator
building or properly. Z0) 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 ❑ natural gas Itl LPG I 1 electric f l
22) More than 4-per outlet
TI E �3U8-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 IE SUSPENDED OR `PLAt:REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER — — — -
WORK IS COMMENCED. TOTAL J
Special Conditions
Date Issued by_ _
6284
CITY OF TIGARD 639.7171 DATE .� 19@�-
BUILDING PERMIT
TAX MAP -_—_LOT NO. _611 ___.SUBDIVISION :`c it i-Iy
OWNER -_ll0m 2_Qz3SSet" JOBADI LESS -J_lnJ_Q__5_!L_Tl_rittanY
BUIL-DER STATE REG.NO. 35533 EXP.DATE
BUILDER'SPHONE 244-3.14
ARCHITECT PHONE ____..___.OTHE".. —
STRUCTURE i.! NEW REMODEL ADDITION REPAIR MOVE L_l OTHER 1 DEMOLITION
f RESIDENCE 1A COMM EDUCATION IND RELIGIOUS n ACCESSORY ❑ GARAGE 1 ! 0THF9 FENCE
OCCUPANCY __!: LAND USF.ZONE __-__U__?_BLDG.TYPE $I! FIRE ZONE _PLAN CHECK BY
ConRtwict Air.p';e f.l,nily tlwellin^ .'gatteclled ara, •, , all per rappooved plana.
Stt;bject to Cada ^t; . `'%lbject to 'mart $360 and t,errn iits . : ISS? .7ewer
,.�I.Itcl?nrrl!el.
SEWERPERMITN 29723 ( l(iu) _ !-antbs : 2 tr Qprwr pdnren : __ I
OCC.LOAD FLOOR LOAD 40 HEIGHT 15 NO STORIES AREA NO.BEDROOMS VALUE 66, D00 {
BUILDING DEPARTMENT v SETBACKS FROMC REAR i" LEFT SIDE RIGHT SIDE
Permit 331 .00 _ THIS PERMIT IS !SSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND !T IS HEREBY AGREED THAT THE
Plan Check 40,C%O 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.
PI.Ck.Fire _ _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
13,24
TAX PERMITS.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax r
'SDC- 600,UI: .:, .
Total 3134 .24 _ PDC# 15Ct•o!' k4A TOR AO T /
Prepd. - 0'aB -
Receipt No.
�� ADDRESS._.. ------------ -- - PHONE
Bal.Due344.24
__- 4 - Issued By— _._.Approved By�
ara wo
DATE INSP. TYPE INSPECTION REMARKS _ PLUMcING DATE
Permit No �
L -- — Rough in _ --
Fix!ure
Final _—
i ror
ATING
— a?
y
_—
— --- ---- SEWER
Final t. "-'_ —
DRIVEWAY
Final
— J Storm Drainage —
lRam Drain)Final
SidewaL'
Curb b Street Final
—` — Approach
BLDG..DEPT.FINIAL CERTIFICATE
OCCUPANCY CERTIFICATE OCCUPANCY Final
' Landscaping
Zoning Fmnl