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3NSPECTIOIi NOTICE
City of Tigard Bui-)ding AerarLoent:
13125 SM Gall Blvd. Tigard, Oregon 97223
Inspection Line fRec-O-�PJhjo)nle)ss�639-4175 a si.nees Phones 639-4171
Inspection:
Footing Plbg. Underelab Hoch. Rough-in Appr/8dw1k
Found. Pibg. Top Out Cas Line FINALS
Post/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Hoch. Rain Drain Insulation -plumb.
Flbg. Underfioor Water Line Oy?• Bd. -Hach.
Date Requested: Time: _AH 7UH
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Addresa: ermit --' �._--
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Ruilder.s -
THE FOLLOWING 00R4LW10NS ARE REQUIRiDs
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Inspectors Date, l�
APPROM e DIBACPRONfO APPROVED sum aCT TO ADM
G11 For IMlnep.
MECHANTCAL
CITYOFTIGARD
MEF'
I T
PERMIT' #. . . . . . . .. MEC9 1 0033
COMMUNITY DEVELOPMENT DEPARTMENT ORE
13126 SW HFd1 BW. P.O.Box 23397,Tigard,Orfipn 97223(603)639-4175 DATE J(,'jSUE D-
1058� ';)W NUk i H DAKU f H f PARCEL: 1BIL34DA-03600
'USLI I V I S I ON. VEMT I Ril CP I R T ZONING: R—ICZ'
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . .
CLASS OF WORK. . :ADI) FLOOR TURN. . . . a EVAP COOLERS:
TYPE OF UNIT HEATERS. . ' k;Ehrr FANS. . . -
OCCUPANCY GRF.,. . :R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES. . . . . . . . : BOT LFRS/COr"1PRESSOR3 HOODS. . . . . . .
FUEL TYPES------------ DOMES. INCIN:
. /WOD/ 3-15 11' '. . . . COMML. INCIN-
MOX INPUT: STU 15-30 HP. . . . : REPAIR UNITS:
F=IRE. DAMPi-'PS?. . : -30-50 HP. . . . - WOOD5TOVES. . : I
GAS PRESSURE. . . : 150+ HP. . . . - CLO DRYERS. . -
NO. Or UNI T*,'3,-----------,- AIR HCANDLING UN I TS OTHE R UN I TS. -
FURN ( 100K BTU: 10000 c:fn:: GPS OUTLETS. -
FURN ) =100K STU: 1 10000 (-.fm ..
Remat-f(s : Existing Woodstoye
Owner. FEES
SANDRA FITZGERALD type amount by date 'i-punt
10587 SW NORTH DAK04(-i PAYM 11 15. 23 JLH
PRMT $ 14. 50
TIGARD C)P 97223 5PCT $ 0. 73
phone #-
("'a n t v-act o t�i
CONTRACTOR NOT ON F11-J--
15. 23 TOTAL
REQUIRED INSPECTIONS
This Derait is issued subject
iect to the regulations contained in the Final Inspection
Tigard Municipal Code, State nf Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This pernit ioill expire if work is not started
within 180 days of issuance, or if work is suspended for Pere
than 180 days.
Iss'.1ed By :
('�nll Fnt- insippetioti 639-4175
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C,T TY T'I GC RU RECEIPT OF PAYMENT RECE I PT NO. z 91-209795
CHECK AMOUNT 15. :37
NAME: d E I T ZGERALD, SANDRA CASH AMOUNT 0. 00
Arjr)RFEib- PAYMENT MATE 02 15 91.
i SBD I V I S,L ON
PURI SCI E. OF 1=`AYMF' 41" AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
IAECHANICAI_ Fi 11F_.C91—(1033 14. 50 ST. BUILD PER_...._._._._ _._ .._,.. V►.�' ,
W[lCIDSTOVF PERMIT
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W.Iff W ffi- N
CITY OF TICARD MECHANICAL PERMIT Receipt# �_�_
13125 SW HALL BLVD. Permit #
P. C. BOX 23397 1 `� Description
T '1
T I GARD, OR 97223 Y Table 3A Mechanical Code CITY PRICE AMT
(.503)639--4175 (i I V 1) Permit Fee -0- 0- 10.00
Name of Development 2) Supplemental Permit 3.00
Job Address — --��--- --_-- 1) Furnace to 100,000 6TU 6,00
Address incl.ducts&vents
Tax Lot Map No2) Furnace 100,000 BTU +
incl.ducts&vents 7. 0
Lot Block Subdivi,ion -- —
Name(or name of business) Floor Furnace
3) incl.vent 6.00
'12 &&R40 — -- - -
MaufngAdnreas Ph" 4 Suspended heater,wall heater 6.00
f1 1
Owner �,� �K O ) or floor mounted heater _
city/State 5) Vent not Incl.in 3.00
appliance permit
Name(or name of business) ` 6) Repair of heating,refs'ig., 6.00
cooling,absorption unit
Moiling Address Phone 7) Boiler or comp to 3 HP 6.00
Occupant absorp.unit to 100,000 BTU
caiv%stain Zip 8) Boller or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Namo -- ) Boiler or comp 15-30 HP
9 absorp.unit1/2-1 million 15.00
Mailing Address Phone i 0) Boiler or comp to 30-50 HP 22,50
absorp.unit 1 -1.75 million
Contractor City state Zip 1 1) Boiler or comp to 50 HP 31.50
absorp.unit 1,750,000 BTU _
State Registration _ City Bus.Tax No. 12) Air handling unit to 4.50
10,000 CFM
I hereby acknowledge that I have rend this application that the information given is 13) Air handling unit10,000 CFM + 7.50
correct,that I am the owner or authorized agent of the owner,that plans submitted are In
compliance with State laws,that I am registered with the State Builders'Board,that the 14) Non portable 4.50
number given Is correct.(11 exempt from State registration please give reason below). evaporate cooler
Vent fan connected
15 to a single duct 3.00
) Ventilation systern not
16 included in appliance permit 4.50
17) Hood served by 4.50
mechanical exhaust
Signature(owner or agent) Date 18) Domestic type 7.50
Describe work [] addition ❑ alteration ❑ repair ❑ Incinerator
to be done residential ❑ non-residential ❑ 19) Commercial or industrial 30.00
Existing use of type incinerator
building or properly _ 20) Other i.e.,woodstcve,water 4.50
Proposed use of heater,solar,clothes dryers,etc.
building or property _ —_ 21) Gas piping one to four outlets 2.00
Type offust- oil ❑ natural gas I 1 LPG [1 electric ❑ ---- --
22) More than 4-per outlet
NOTICE
SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- — —
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR !-PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -- -
WORK IS COMMENCED. TOTAL
Special Conditions
—_— —_� Date issued._ -by __--