10395 SW JOHNSON COURT-1 10395 F-W JOHNSON COURT
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection —
a
Date Requested P.M.
Address Permit #_—
Owner tot #
Builder _--_-_ 2 0– t2&-LSIV
The following Building Code deficiencies are required to be corrected:
4
Presented to __ _._ Approved
Inspector _
Disapproved
Dote
CALL FOR REINSPECTION
C7 YES ❑ NO
ILA I Y ur- I IUAHU MECHANICAL PERMITPermit
Oescrlpllon
rabla 3A Mechanical Cods a" PRICE AM
City of Tigard --
13125 S.W. Hall Blvd. 1) Permit Fee -0- -01 10.00
P.O. Box 23397 -- — – _
Tigard,OR 9,223 2) Supplemental Permit 3.00
639-4175 iFurnace to 100,000 BTU
1) incl.ducts&vonts 6.00
Furnace 100,000 BTU +
�)_incl.ducts R vents 7'50
Name d evelopnhent Floor Furnace
�) incl.vent 6.00
Job Addrea% -- -uspended heater,wall heater
Address /U 3 1}.��v i,, e z` 4) or floor mounted heater 6'00
Tax I W6 No - Vent not incl.in
Lot BIN* subdivision �) appliance permit ,- 3.010
Name(cc tmv"of business) 6) Repair of heating,refr ig.,
c-cling,absorption unit 6.00
Mailing Addretuh r p - Boller or comp to 3 HP
Owner ) absorp.unit to 100,000 BTU 6.00
cityrslsle ZIP 6) Boiler or romp to 3 HP- 15 HP
11.00
absorp.unit to 500,0(N.'3TU
Nam. 9) Bailer or comp 15-30 HP y^ 15.00
� � _F,b_sorp.unit 112-1 million
Me"Address Plwrr 10) Boller or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million _
Contractor cltyi9ute -- 74Boiler or comp to 50 HP
11) absorp.unit 1,750,000BTU
31.50
sla»paplstrsllorh No. (Ay&n.Tu,�, 1?) Air handling unit to 4.50
_ 10,000 CFM
I hereby.durowliedge IhO I nave ..,b#*appeeethx,ow the a,lor"wom " is 13) Air handling unit 7.50
_
coned,ew I am Ma owner or auft-ired aperhl d the owrher,lhal plana subrnitlad w In 1_0,000 CFM +
oompflarwa win,stale laws.t»l I&m 1e91sNred with the Stab(AMP,#'80ard.that h„ Non portable
is o0rn1a1 (11"amp,km stall reglaftation daae+p+w reason bel1ow) ) evaporate cooler 4.50
Vent fan connected -
- 1' to a single duct 3.00
- --^ - Ventilation system not
---_ -- — �� 16) included in appliance permit 4.50
f Hood served by
i - 17) mechanical exhaust _ 4.5(1
of - -- Data 18) Domestic type 7.50
De scribe work [_ addltlon ❑ a"eratf0n,j repair (� Incinerator
If)be done residential EJ non-residential
[7 Commercial or industrial 30.00
Fxisting use o' 19) type incineralor
building or properly ,✓ 7Z� Other Lei Woodstov�,wilier
Proposed use of
20) Other
solar,�tfi99 drvers,etc.- - ,•50
bulldinj or property--_
21) Gas piping one to rout outlets 200 -
Type of fuel-- oil I I natural gas I J LPG I] oWctrlC L1 --- - --- - - -
22) More than 4•per outlet
NOTICE - - - - - —
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- --------SUB-TOTAL
STRUCTION AUTHORIZELI IS NOT COMMENCED WITHIN 180 S&/O My SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK. IS SUSPENDED OR PLAN REVIEW 25%OF SUS-TOTAL -
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIMF AF-TF17
WORK IS COMMENCED --,---V" -W-• ___._ TOTAL.
Special Conditions
_ - - Date issued - by
i
1
PERMIT TO CONN ECT °
Tigard Sanitary District
6
PERMIT N° 7 6 5DAT: -r
PERMIT IB GIVEF TO
TO CONNEG9 A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MUS BE POSTED ON THE DES InED PREMISES IJNTII.{,OM-
NECTION IS MADE AND INSPECTION OF (".ONN'F.CTION HAS BEEN
PLETED.
PERMIT FEE PAID .... ............................
.wA
CONNECTION INSPECTED AND APPROVED
guperintendent
Address /d 3 y�S.lU ^T�/�:s�'.� C Permit No..
Name of Occupant &M_ Permit charge_
ConnEction fee �r
Paid by � �i Iloe.t
Date connected i�- .5� b�r/
g�/ c e
Type of Building r, DEN�` Inspection fee /
Service Rate - _ Paid by —:7-W, Dai9 h-
Contractor_7 %i���' �' As5essment Paid_ _
A
Size of connection _ 4'