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PURCHASE / CHECK REQUEST
VENDOR +r1�gp- 4 ��}/0P atl),:rg _....
27 ADDRESS
CITY OFTIGA RD -
DATE I� 2 REQUESTED BY � �(C �. UNIT/DEPT. PD
PURCHASE REQUEST CHECK REQUEST
PREPARE; PURCHASE ORDER CHECK TO BE MAILED o.t ei—ni ihelI'.E':`�'�
1 SEND CONFIRMING P.O. �� NOTIFY REQUESTER WHEN CHECK IS READY
SPECIAL INSTRUCTIONS CHECK NEEDED BY
ACCOUNT NUMBER QUANTITY INVOICE NO. & DESCRIPTION TOTAL PRICE
I �' ,2717
/40
TOTAL REQUESTED () '
I
APPRUPRIATION BALANCE
Amount / Init.ials
APPROVALS:
SECTION MANAGER (Less t-han S100)
s
DEPARTMENT !LAD
CITY ADMINISTRATOR'S APPROVAL.
___________________ ACCOUNTING PURPOSES ONLY
Amount Paid �+ 8ignat.ures Checked
P.O. No.
Check Number Fin. Director
Date Paid
DEPARTMENT FILES
N K�ffi I
Cl$y- ®f Tigard Mechanical Permit
'sowft.allation lexReplace Relocation Addition ❑ Alteration a DATE: 12/21/82
HEATING
CONTRACTOR _ Imperial Mech. OWNER _ Grand Develounent _
ADDRESS POBox 06327/Port1and 97206 JOB ADDRESS 11180 SW l=ien Ct.
PHONE 177-3801 APPLICANT Inlperia-l. Mech.,/44= —_
Heat Input RatinglBTU per Hnur) .8000 s/Pnt Sire-- _. Flue Size
FUEL OIL GAS ELECT OTHER
—� te
ITEM _ NO. FEE ITEM NO. FEE
S ._F -
For Issuance of Permit S_EE BELOW h Air Handli Unit or Duct System 7.50
N-w-up to &. incl. 100,000 BTU _ 6.0_0 ^Commercial Hood System _ _ _ 7.50__
New 100,OOU BUT's & over7.50 Other Equipment - Each — _ 4.5f_
Woodburning Stove 4.50_ 1 Trip Inspection -- _ _4.50
Wall-Floor- Suspended — 6.00 Air Condition Compressor - up to& incl. 3 H.P. 6.00
Vent System w/Fan 1A 4.50 Air Condition Comprressorr3.1 to 15.H.P. incl. 11.00
^ 1-1,-3tCer,!ir�W 60
_ CITYBUS:NESS LIC NSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ? !
PERMIT ISSUANCE 10.00 Ca�'•menta: we are asking for reitu,d on permits 2773 and .3254,
_ L tx> {(� . heating system being i ns a s c ang
ed to
FEES
dd**_ ...
SIB-TOTAL
— % STATE Issued By. --
BUILDING PERMIT APPLICATION TIGARD DATE___� D�' . :3 ti ,s_ __' 4253
THE UNDEFIGIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE '~_�
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICAT,ONS. OWNER PHONE:
OWNER f-7-r• a d Dey ct). _JOB ADDRESS _ _ . • LOT NO.53 i_'.:_m_0n 's
_
.L - ��QFFt `i�r)� i'ti110-_n i 1*0SI Itt, 4a}ll,ff
BUILDER` ADDRESS _ESGNER
STRUCTURE ® NEW ❑ REMODEL _ ❑ ADDITION ❑_REPAIR El RENEWAL G] FIRE DAMAGE -_❑_DEMOLITION
RESIDENCE fel COMM El EDUCATIONAL L7 GOV'T ❑ RELIGIOUS ❑ PATIO ❑ CARPORT U GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _ LAND USE ZONE �+"T O BLDG.TYPE_ S!''TL_FIRE ZONE_..__PLAN CHECK BY HEAT
l":`_"t :yin tlt 57e1'l.i]_�� r l�lrtrt w'attnched crarwin --
_^ ,orroction E;hnr%t =itt.Achecllltt
SEWER PERMIT# 'r -
47-5
OCC.LOAD FLOOR LOAD HEIGHT NO.STORIES__ AREA -1-17r' NO.BEDROOMS 4 VALUE
BUILDING DEPARTMENT n R �., - - -"
-- SETBACKS FRONT 1 REAR i LEFT SIDE RIGHT SIDE 1
Permit _ _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL PPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check � 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
Sub total RESTRICTIVE COVENANTS. CONTRACTOR AND PUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State lax IS LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMB111G AND HEATING.
Total _ SDC- 401
By .lin j PDC# I �U APPI.ICA NT OR AGENT
Approved $L1 Receipt No. -��-___
I�VI)1'I S PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
T
Contractor g V� tS_•-y11��
Permit No. 32 Eli 141,40
-is •yJ ` .`
Rough-in
f 3 A, Fixture -- —
/-:2D.. _ Final --- - --
/- - HEATING
Contractor
qM Permit No,ZMQ� 2
°i776* 2B.Z 16,b9 2:22-8z
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb&Street Final
_ Approach
BLDG. DEPT.T INAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final
i3
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