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11590 SW NORTH DAKOTA STREET 11590 SW NORTH DAKOTA STREET ._ x r� z in rr, �f� ssu .r � ssw ■ssr � es sssr A INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 11 Tigard, Oregon 97223 Phone: 639-417.5 Type of Inspection — Date Requested_.__ Time f.r Akm. P.M. Address f_,���1� Permit Owner--_---- ��` _ Lot Builder�.- — - — - ---- -The following Building G,de deficiencies are requ;red to be corrected: Presented to� ---- -- -- - -- - �Z�Approved Inspector -- Disapproved Date -- CALL FOR REINSPECTION ❑ YES Ll NO Nut 11111111-ALMIA&M-AU F- CITY OF TIGA RD ��,C,, MEC'HANI(-,Al PEIPIMV11' COMMUNITY DEVELOPMENT DEPARTMENT onto*" PErAMI'T' NO. ME98066e 13.25 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223.(503)6394175 PP1M . PMT .NO - (3e0668 JOB ADDIPIESIS : 1.1590 SW NOPTH DAK('.)*T'A 15T 'TAX MAP/I---0'1* 1.3LJB 8K : LAND USE' 0 T 51:Z r--' NO : NO: .1 T AVI HANDI—r-4 <10 W011K C11 AW;i - ADD11*10N FUIPINACE: <11-00K 1. U5F. l'Yl*-'E : G1W.A.E FAMILY FLHINACE 1.001<4- A1P HANDLP 1.01K L'ONG1* .'TYPE: VN F*J-Oon FURNA("E I:!:VAP . COOLEP P3 FIE-ATE.P VENT' F'FiN VEN'T VE:N'T . C)YS'I*r!:M DLP/COMP <3tif" HOOD NO . FS'Y*OPTE:!:; : 2 3-15HP 1NC1NE.:PA*T0V4(DOM DWELL . (.)WETS : 15--30HP T N(-:r NE PAJ'O P(COM '30 30HP REPA1P UNI'Y'S FLIF-i'L. 'TYPE. ELEC',' . pl. r4 c 7'THEP MAX . SNPU'T' ,OMPPIPING OLYTI FT FTPE DMIPPS"? LOW PPE557 PE"MAIUS : Add---c)ri heillA PU111P . 0 1---*!5 W PERM T'I' $10 , 00 N johri atricl M a r•:i.lit. E Pl AN 1P1F-:VTr----W R '!.iW Nol"th Dilik01,19 $6 00 T if u ril.r,(1 011 C 0 Nr T I OPEKGON HEA'T PUMP A (*.)PF(.,()N HEAT' PUMP C t.?P00 NE RPOAL)WAY T p o r,t I mn(J or- 9723P 0 R PHONE ( 503) 'TnTAL. : $1.6 .flo R E Ga T'S TTFA7TM -14n. -ITS ATPF— This permit 18 issued subject to the regulations contained In Title 14 NO . 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 REQUT.PED INSPEC"I'TONS specifications and in compliance with all applicable codes and F'OUTT NG ordinances The issuance of this permit does not waive restrictive covenants. Contractor and subcontractors shall have current city MF:.(',1-4AN(*,I.,. . SYS'VEM business tax permits This permit will expire and becume null and F)l B UNDEPSI AD void if work is not started within 180 days,or it work is suspended or PLIS 1J)POU'l, abandoned for a period of 180 lays any time after work has 1-1 NAI commenced. It shall be the responsibility of the permittee to assure all required inspections are quested and approved. Permittee I n ire I Issued Ry &ENCAMI" SEPARATE PERMITS REQUIRED FM'*O-T'M' ED ABOVE w w MECHANI(:As... PEPMI'T CITY OF T167A RD ; PE WMT T NO. MF:Hf3n�,6<? CITY OF TIGARD ooeooN COMMUNITY DEVELOPMENT DEPARTMENT At e/88 13125 SM Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 PRIM . PM'T .NO___ .JOB AI7DRE 5 : 16995 SW MATADOP LN TAX MAP/I...UT F:UB: LT : SK : LAND USE : LOT 5 1:TE :I:'T'E:M: NO : NO: WOPK (:',I...AS!:.i : AI_JE.:PA'TT0N F"UPNAT.:F:. <100K rilA HANDL P <y.n a. USE.: -TYPE : SINGLE' FAMILY FURNACE" 1001<•F AIP HANDL..R 10K CON5'T . 'T'YPE-.: : VN F'I._OOP I:1'1.1r�NAC:E: :E:VAIn' . C'001_F Fe OCC:UP . Grip . : 1..13 I-IE::Ai'EP VENT F'AN VE:N'T VENT' . SY';'TF::M Cd' r''/(:;OMP <3HP NO . 5TOU111h'S : E _WC'OMP :'i- 1."SFir> ]. .T.NC TNEnA TOP(DOM DWEI...L L .UNT'TS : I'al...P/COMP 11....30HP TNCINI';:nA'TOF1(COM F:'UF--I_. 'TYPE: E'I...E::(:: . VA.-A/(:OMP 30 :'WI-Ir-' I.7E.PA11141 UNITS MAX . :I.NPI.)'T 1:31_I:1/COMP '504-HP (I'T HE:11 F*1PE.' 17MP17ta'7 CTAS r)TPIN(.v OUTL..E:'T'S 1-41GH PPE SsS7 RFF:MAPKS : J.r1 to t ai a :1. F1 m r►t, I:�cI m I:� F:RE_S O l'ILI1-`:1.L)t.ir•t ea►t^:L PE:1..1MI'T 11111111.0 , 00W N I.69195 mw m>Htmci131'� Irt Pl...AN PEVIEW R It J.rt g c•i.t y u t� 9'7'r."..'PA F'T X'TY.)PE C., t11 1 . 90 PHONE: (n03) 639-6352 !i'T'AT'F: TAX M t .SAH OTHER C O N T HIJP*T BI:1(7!:i INC . R ISO BOX 4169 C 970A!5 T PHONE: ("50;3) 6,56-`3411141- 0 r TOTAL_ : 1111126 . '7(3 R F)EGl..il'FIAIJON N(7. 3 1'709 RE=C ETPT NO. 11PIP This permit Is issued subject to the regulations contained In Title 14 ............... ..._._.�.-..-._• of the TMC. State of Oregon Specialty Codes,zoning regulations l� QUIREC) INSPE TTC)N5 And all other applicable codes and ordinances, and It is hereby agreed that the work will be done in accordance with the plans and F TNAL specifications and in compliance with all applicable codes and ordinances. The Issuance of this permit does not waive restrictive covenants Contractor and subcontractors shall have current city business tax permits. This permit will expire and becorne null and void If work is 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 be the responsibility of the permittee to assure all required inspections are requested and approved. Penni ignature --- -"" �r Issued By: J ---- - 117AT.:1- FrM. - SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AgPVE -cc BLUA-DING PFPMJ:1 C'� OF T'�� * mol:TwAiw 1:)EAMT T NO I-)L)6 U%0 A 1.0 COMMUNITY DEVELOPMENT DEPARTMENT 13125 S W.Hall Blvd,P.O.Box 23397,Tigard.Oregon 97223,(503)639-4175 - - J01,9 ADIA-41ESS : 96P.4 SW WASHIN(.*,T0N SQ . RD . TAX MAI:)/1 (.31, 511-1FI : WAS&H.M.4"TON 5QUARE I.. y HK : LAND LISE : 1-01 SIZE : VAI.A.IATION . s 3. 7 ,000 SETUAt"KS F111314T . illi Aft WORK GLASS : ALTEPATION DWELL. UN ITS' : LEFT : 1.41J"VIT : USE 'TYPE: : COMIMIC14CIAL NO. DE DPOOMS EXT WAI I CNINS'r . TYPE: VN W.I. BATHS : N 5 E : W OCCUP .GRP. FM P11,10T .OPENINL.,S : ()C'C1JI-*' . L LAD G 15 N S : E, W T'Al A V.4 L.".A :3:1.11:10 NO. STURIES :1. IS T : t?190 1400F (:,ONST : HEI G HT : PND AVII:.:A SELVA147 PATED BASEMENT7 N(J MW: (JCX'1-JVJ. SEPAR7 RATED: Mr-.:ZZAN I NE 7 NO DASKM'T FLOOR LAW) . 1.00 G A P A G F V 1*1:41;:: SPPIKI-P? ALA141`17 I-IIEF411 I ypit L,;n, V[J)w ('.IPM I 11;l I, f-11 I.J.—O-Cf Y 1:1.-AN BY : JhJ PEMAWKS : Tc.)rinnt mri(j . - W.J.i.auri St.ioplijia. PEISSUE OF NO. I-AST REISSUE 0 FEES : W fv1#.4:I.VJ.,lA.r!1 Pelli.1ty G'a . Pll�.:PMIT I N V�:-2 5 0 :3000 E W V th t.C'I I a to t,0 1" A V 0. P1 AN W."WA-i"M *79 . 613 R NY 10*328 DEPT *4'9) . 00 PHONE ( 51 1.4) P53-8000 STATr-ii. I A X $6. 3.3 G 0 DEVELOPMkKINIT ('.,HAAGF!-.s : N 50C 11 S'T'ORM) T R GAMUT INC. 1"IX1.114TRER-1,11 A 1:)(:)B I' C X:I.!7)Alo C.,A 9-1,566 P14EPAID $12R . 6,5> 0 V"HUNIlin. 141.'11 4401-411PI4B I rAL-J'.71-STRAT'ION NO. GUM1,11, TOTAL: f11.2B , 63 This permit is issued subject to the regulations contained in Title 14 RECEIPT NO. 29F439 of the TMC, State of Oregon Specialty Codes,zoning regulations and all other applicable codes and ordinances. and it is hereby PEQUIPF-D 1NSr.'+.:C—TX0NS agreed that the work will be done In accordance with the plans and F-44AMIM., specifications and in compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive INSULATION covenants Contractor and subcontractors shall have current city ('.'.YP . ROAM business lax permits This permit will expire and become null and MECHANC 1L. , SYSTEM void ifwork is not started within 180 days.or If work Is suspended or SUSPEND.CA-:11-INC, abandoned for a period of 180 days any time after work has commenced. It shall be the responsibility of the permittee to 13SUrp, all required inspections are request approved F.T.NAL P mittee ig a re 'a Ure #- B y d Isst ("All-L. ll"0111 TNNPF,:'C-TT0N 639--11.75 SEPARATE PERMITS REOUIRED FOR WORK OTHER THAN DESCRIBED ABOVE INSPECTION NOTICE City of Tigard Building Department 12420 S.W. Main St. Tigard,Oregon 97223 Phone: 639-4171 Type of Inspection -`� Date Requested ��/ [ f -Z- _ Time A.M. P.M. Address -1Z., a � � Permit Owner_ - _—_— Lot # Builder The following Building Code deficiencies are required to he corrected: r AJkly Presented toVed � ---�--- --- Inspector _ Disapproved Date -- — -- -- f CALL FOR REINSPECTION YES ❑ NO m INSPECTION NOTICE City of Tigard Building Dapartmen, � C•r� 12420 S.W. Main St.Tigard,Oregon Oregon 97223 Phone: 639.4171 �(�,= ��AZO, Type of Inspection Date Requested - f l 9 > Time A.M.✓ P.M. Address _ .Lv _ Permit # Owner_ ' " °� lot # Builder The following Building Code deficiencies are required to be corrected: it i Presented to -- —--- � � Approved Inspector [] Disapproved Date CALL FOR IIEINSPECTION ❑ v1:s 0 No City of Tigard Mechanical Permit N_ 3 8 4 0 New Installation Replace 0 Relocation Ej Addition Alteraf:.,,. DATE: LZ. HEATING �� x�� ER N CONTRACTOR ADDRESS 'Z L� JOB ADDRESS PHONE=� APPLICANT Heat Input Rating(BTU per Hour) _ Vent Seize Flue FUEL OIL GAS [] ELECT OTHER ITEM NO. FEE ITEM — NO. FEE— For Issuance of Permit SEE BELOW Each Air Handling Unit or Duct S sy tem 7.50 New-up to_& incl. 100,000 BTU 6.00 Commercial Hood System _ 7.50 New 100,000 BUT's & ov r 7.50 Other Equipment - Each _ 4.50 Woodburnin_ove �i4_ �.� 4.50 1 Trip Inspection 4.50 Wall-Floor- Sus ended _ -- —_ 6.00 Air Condition Compressor - up to& incl.3 H.P. 6.00 Vent System w/Fan _ — 4.50 Air Condition Compressor-3.1 to 15. H.P. incl. 11.00 Repair- Heat Cooling 6,00 --- CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! ! PERMIT ISSUANCE 10.00 Comments: FEES --- -- SUB-TOTAL 1Y .. _ ,_ ---- _ _ ---- ------ -- % STATE Issued By 25%PLAN CHEOK L .�--- TOTAL_,^ J.O� REC. _ , gn u e o Applicant - -s.Awqwov"NPI�:'°'V."r wyMK+�M'+--<...is •v^,}p.r�7w�"JD1�'w"'Y�r..A„n .�,.,r�.w+w..r.,.r. ,. CITY OF 550 2 r BUILDING PERMIT APPLICATION TIGARD DATE_ _, 19-�- 0 3 Z THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE OWNER I`'�tl!/ ADDRESS BUILDER PHONE i?�<15118i ENGINEER BUILDER _ ARCHIT 1'__. _ DESIGNER — STRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL. ❑FIRE DAMAGE ❑DEMOLITION ❑ RESIDENCE ❑COMM ❑EDUCATIONAL. ❑GOV'T CJRELIGIOUSOPATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB [3FENCE ❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS OCCUPANCY_.__LAND USE ZONE t�,,,7 BLDG.TYPE - FIRE ZON�_ PLAN CHECK BY__` — NEA' : ,nt;ract 12 x 22 petiu ..,� poet* A x 6 boom - -- -- x 6 rafters 2 x 6 ledger Joist Hangers -- — �__� - a ext. plywood sheathing coop ohingl.es QCC LOAD FLOOR LOAD HEIGHT NO.STORIES -----,AREA —VALUE BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE == - ------ --- Permit -- THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Recording ALL APPLICABLE CODES AND ORDINANCES, THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS 1%State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING, AND HEATING. Total `a 105 By rfs — -- -- APPLICANT OR AGENT ........- Approved Receipt No. r ADDRESS t Fii DATE INSP- TYPE INSPECTION REMARKS PLUMBING OAT Contractor Permit No. Rough-in Fixture Final HEATING Contractor Permit No. Gas or Oil Final SEWER Final DRIVEWAY Final (Rain Drain) Final -- Sidewalk Curb 81 Street Final Approach CLOG.DEPT- FINAL TEMPORARY CERTIFICATE OCCUPANCY CERTIFICATE OCCUPANCY Final Landscaping Zoning Final ......... . . . ........ ..................... BUILDING PERMIT APPLICATION cOFY TIGARID DATE 10/27/ THE UNDERSIGNED HEREBY APPLIES FOR APE RMIT FOR THE WORK HEREIN INDICATED 13UIL.DERPHONF _ OR AS SHOWN AND APPROVED 'N THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONh—___.r_-_-_ 10O LOT NO. Strost OWNERS 0flf) i`_', ; A A i 1 i JOB ADDRESS 1 i. 6 Sly N. LlNiktl_ta HOrtr,Annl:ESs ARCHITECT ENGINEER BUILDER _ ADDRESSt-� f)ESIGNE_R____ STRUCTURE _ONEW 0RIMnDEL� ❑ADDITION Ol "RFPAIR 'IFNEWAL �OFIREDAMAGE ❑DEMOLITION 0 RESIDENCE OCOMM ❑EDUCATIONAL OGOV'T ❑RELIGIOUS OPATIO ❑CAH PORT ❑GARAGE O STORAGE OSLAR OFENCF OBOND ❑MOV ING [:]CONDITIONAL USE. ]DESIGN REVIEW ❑COUNCIL APPROVED L_)SIGNS ` 4,l �. „I OCCUPANCY "'J .LAND USE ZONE-_--` BLDG.TYPE _FIRE ZONE_Z PLAN CHECK 8Y HEAT.-- 10, x EAT_1G, X 09jgirstyj ander ()CC-Q_9QL BUILDING DEPARTMEN f SET BACKS FRONT REARLEFT SIDE RIGHT SIDE Permit -' THIS PERMIT IS ISSIJEO SUBJFCT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING Plant Check REGULATIONS AND ALL APPLICABLE COPES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE -- WORK WILL BE DONE IN ACCORDANCE WITH THE PI ANS AND SPF 1:1 FICA TI ONS AND IN COMPLIANCE WI1"H Sub-total ALL APPLICABLE CODES AND ORDINANCES. TIIF ISSUANCE OF THIS PERMIT DOES NOT WAIVE -- RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS State Taxa `20 LICENSE. SEPARATE PERMITS REQUIRED FOR P -..VER, PLUMBING AND HEATING. Total ' 'i i V By _ PI AP_..PI__ICA__N__1_. . .--- riR Approved Q' olldsoi Receipt Nol;'_; mmuffjil�� w I= Km 3'JILDING PERMIT APPLICATION "'YTIC,",RDDATE-1�- No 2-19'Y" UF iNDE PSIGNIED HEREBY APPLIES FOR A PERMI1 FOR THE WORK HEREIN INDICATED BUILDUP I"140NE AS SHOWN ANDA PROVED IN THE ACCOMPANYING PI LNS AND SPECIFICATIONS OWNER f'H0NE­­----­­ ARCHITECT - V - LOT NO- &E�_A S ENGINEER ADDREIS DESIGNER URE ONEW EIREMODEL DUIfI(JN Q REPAIR ORENEWAL EIFIFIE DAMAGE ODEMOLITION NCF F]COMM (3EDUCATIONAL 3row1 n, IOUs &2m(LOCAPPORT 0GARAGE STORAGE13SLAS CIFENCE CI — 14OND OMOVING OCONDITIONAL USE 0DESIGN REVIEW DCOUNCIL APPROVED EISIGNS CL �NgY *A/FfRF ZONEj- HEAT_ - _ K*�_ A��D.USE ZONF­JR-f1­BLDG TYPE.- PLAN CHECK BY LOADHFLQH-L*1-V --kQAjjQfljkt_ AREA BUILDING DE-PARI MENT SET SACKS I RONT REAR LEFT SIDE MIGHT SIDE THIS PERMIT 19 IS%LJED SUBJECT TO THE RFGL)LA7IONS CONTAINED IN THE BUILDING CODE, 70NING PlanRFGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HERFRY AGREED THAT THE. E�heck WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN C,)MPL IANCE WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE ------- RESTRICTIVF COVENANTS, CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS LICENSE SEPARATE PERMITS RF0UIRFD FOR SEWER, PLUMBING ANO L4cATING. By APPI ICANI OIi AGE NT - A,ipi oved eceipt No f ■ 'i i I CITY Of April 26 7" N2 0770 BUILDING PERMIT APPLICATION TIGARD DOTE— --- 19_—_ THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PbNS AND SPECIFICATIONS. OWNER PHONE OWNER juhi I N•,rilii —__ADDRESS ' r`,. r • aNCOt.B BUILDER PHONE _�._. ENGINEER BUILDER s0InCA ARCHITECT _- _ DESIGNER STRUCTURE ❑NEW ❑REMODEL ❑ADDITION, ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION ❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO [:]CAR PORT ❑GARAGE [:]STORAGE❑SLAB [:]FENCE ❑POND _ ❑MOVING ❑CONLITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS -� OCCUPA_N_CY—. -LAND USE ZONE---SL!)G.TYPE— FIRE ZONE PLAN CHECK BY— __ HEAT mstiuct 101x2:,' r, ,u r. fibergla*8 rUUf Ouwr kx(; 66xi1I(Jt1rG ithl 4x6 header, - OCC. LOAD FLOOR LOAD _ HEIGHT NO.STORIES AREA VALUE BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE�- Permit - ---` — — THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE. BUILDING CODE, ZONING Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE -- �� WORK WILL BE DONE IN ACCORDANCE WITH THE PIANS AND SPECIFICATIONS AND IN COMPLIANCE WITH Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE RESTRICTIVE COVENANTS CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS I State LICENSE. SEPARATE PERMIT'S REQUIRED FOR SEWER, PLUMBING AND HEATING. Total --��x�-- Bv ---ORA APPI.ICANI GFNr Approved Receipt No. AG)ORESS ---------�--.. PHONE—---- lKlWAPs'klWJLW_jmmmL_=JLwK PERMIT TO CONNECT Tigard Sanitary District PERMIT N? 1186 DATE�[' •� PERMIT 18 GIVEN TO OF TO CONNk.(JT ATO THE STSTEM OF TIGARD SANITART DISTRICT a �. THIS PERMIT MUST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON- NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM- PLETED. PERMIT FEE PAID ...........TIGARD SANITART DISTRICT,,. G By CONNECTION IMPUTED AND APPROV%D i Address _�/Zj A/ 1-22-1.,11alk Permit No. Permit charge Owner Connection fee �;�'S?�, A--n Paid by Type of Building �,�� Date connected Service Rate �,,J, d'D Inspection fee Contractor Paid by _Date Size of connection`_/ Assessment Paid I h. tc��uli�C .r — l' H Y OF T IGARU MECHANICAL. PERMIT Permit 11 k ity of Tigard 1 312'1 SW Ha 11 111v , Deecripllon --- — P.O. tl.,x 23397 Table JA Mechenkal Code QTY PRICE AMT Iigaid OR 97223 t, 19 175 1) Permit Fee -0- -0- 10.00 2) Supplemental Permit 3.00 1) Furnace to 100,000 BTU incl. ducts & vents 6.00 2) Furnace 100,000 BTU + _. Name of Development incl. ducts & vents _ 7.50 John & Maria Lain - 3) Floor Furnace Addroas incl, vent 6.00 Job 11500 SW North Dakota - Address Tar Lot Map No. 4) Suspended heater, wall heater Lot ©lock Subdivision or floor mounted heater — 6.00 5) Vent not incl. in Jahnn & MariaKain Name f name business) appliance permit 3,00 ---- Melling Address Phone 6) Repair of heating, refrig., Owner 11590 SW N. Dakota 639-9083 cooling, absorption unit 6.00 0ity/stat, ZIP 7) Boiler or comp to 3HP Tigard , OR 97223 absorp. unit to 100,000 BTU 6.00 Name 8) Boiler or comp to 3HP-15HP Oregon Heat Pump Co . absorp. unit to 500,000 BTU 11.00 Mailing Address Phone 9) Boiler or comp 15-30 HP' 2200 NE Broadway 287-1233 absorp. unit th-1 million 15.00 Contractor City/State ZIP 10) Boiler or comp 30.50 HP Portland , OR 97232 absorp. unit 1-1.75 million 22.50 State Registration No. City Bus. Tax No. 11) Boiler or comp 50 HP 8(CF)� Cy000� _?._2 absorp. unit 1,750,000 BTU T 31.50 _— hareby acknowledge that I have read this application that the Information 12) Air handling unit to given Is correct, that I am the owner or authorized agent of the owner, that 10,060 CFM 4,50 puna submitted w In compliance with State laws, that 1 am registered with rhe state Builders' Board, that the number given Is correct. fir exempt 13) Air handling unit from Stats registration plssse give resaon below). _ 10_,000 CFM + _ _ 1.50 14) Nun portable evaporate cooler — 4.50 15) Vent fan connected -- to a single duct _3.00 _ 16) Ventilation system not Signature (owner or agent) Date included in appliance permit 4,50 — 17) Hood served by Describe work ❑ addition[] alterationEJ-iopair❑ mechanical exhaust 4.50 In be done residential ❑ non—residential [I 18) Domestic type Existing use of incinerator — _ 7.50 — budding or properly 19) Commercial or industrial Proposed use of type incinerator_ — — 30.00 building or property 20) Other i.e., woodstove, water I ype of fuel — oil❑ natural gas[ LPG❑ electric heater, solar, clothes dryers, etc. 4.50 NOTICE 21) Gas piping one to four outlets 2.00 THIS PERMIT BECOMES NULL AND VOID IF WORK OR 22) More than 4-per outlet CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN SUa TOTAL 180 DAYS, OR IF CONSTRUCTION On WORK IS SUSPENDED e�—*% SURCHARGE ,8 U OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY -- ---- TIME AFTFR WORK IS COMMENCED. PLAN REVIEW 25%OFSUB-TOTAL 14 TOTAL Special Conditions _ -------- ��- —T—Y� Dald i5SI1ed by ..—