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CITY OF TIGARD BUILDING INSPE TION NOTICE
Inspection Line (Rec--O--Phone,)(: 639-4175 Business Phone: 639-4,17711 I
Inspection: �YY ��r l �J`�-�LyKN
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab ech. Rou h-' "� Fireplace
Post/Beam Siruct. Plbg. Top Out Elec. Rough-in FINAL:
Post/beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb. "
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Alarm Water Line Insulation Much. /
Underflr. Insul. Shear Wall Gyp. Bd. -Elect. r
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Date Requested: Z 2 Time: AM PM
Address:Builder: r �� ' O40 Permit 5 0 S . a
THE FOLLOWING CORRECTIONS ARE REQUIRED:
t 9-ST t 0 a
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c.� �ti1110 5 Z ► 1 _
Ins tor: �% Date: 17,
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.
CITE' CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT "
13125 SW Hell Elvd.Tigard,Oregon 97223.8199 (503)836-4171 ''L i!Yr1p i.NO Pt-F',
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DATC 1 rSLJED:
rr}tr-,(-'f. {_.. 17-,1�..J r.41/:.i "CI 6
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- P'`1' '. J' 1 0c)/19/1'),- - :r 4.1%ql 1,
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ThiE persit is issued sakject to
Tip—i kricipal Code, ";' .r
applicable Ibis. All
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City of Tigard PLUMBING PERMIT Planck/Rec. #
13125 sw Hail Bird. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
escnpUon 1
j Z ORS 814-21-6 10 '�� OTV PRICE AMT
J& G sbo N D, FIXTURES
AddreS3 Smk
vatay —
rI ub or Tublr� ower Comb.
ShowerOnly
a er osa �
Owner G� )s 5Z AJ. ' 77 i wa er
ge
-Di --730
as ng Machine --- 7.50
-
-r` rant r
Water Healer -
v,�-- -- Laundry Room I ray
Occupant J enc — nom— _ 7.50r
Oifier Fixtures ea
y'I —
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Contractor MISCELLANEOUS
� --
l.� Sewer Ist
��� sewer-ea�ii3�f�' b�tT
a ar-Serva I s -
-I here ac now aI nave re5d t1iis application,' - Wale.Service ea.Addit.200' 15.00
irformation given is correct,that I am the owner or authorized agent of t.
the owner, dial plans submitted are in oompliagce with State laws,that I Storrs d Rain Drain 1st 100' 30.00
am registered with the Construction Contractor's Board,that the number Storm 8 Rain Drain Addit. 100' 15.00
given is correct. (if exempt from State registration,please give reason —
below.) Mobile Home Space 25.00
--�-— Back Mow Prevention —
Device or Anti-Pollution Device 7.50 `9
•�-^« -- -�- 7Uiy ra-p- r Wa-sWV.uT— -- -�—
Connected to a Fixture 7.50 ;
Describe work new Ua iuon a terabon repair — Catch Basin 7.50
to be done residential Q non-residential Q a!'
Insp.of Exist.Plumbing per hr
Specialty"-•^sled Inspections per hr
Existing use of Rain Drain,smg ami
building or property __—_— dwelling 15.00
Res ntial backnow prevenbon
devices 15.00
Propused use of -- — --
building or property _
'(Except rosidonUW ba-c-Mo—w —
prevention devices)
NOTICE •YLrlm-m Fee$25.00 SUBTOTAL '7L j
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5%SURCHARGE C
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF —
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED p REVIEW 25%OF SUBTOTAL.
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED.
Special Conditions — TOTAL--T-'---
Date issued by
An PI.UMBPM I
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TIGARD MGCt 1f•1NTTCF' YOF .
FEFvMIT d�. . . . MEC95
C'. JITY DEVELOPMENT DEPARTMENT -;,n•T E I SSUe'`.'.D: 0`a.'1,9:19
t 1312. ull Blvd.Tlgsrd,Oregon 97223.8199 (503)839.4171
I I �ftC;CL: 1 a 8C12`r'
' s~ it w e ?05 rDW t lC� -7 7(Y" :'
"iiJTl:i14 2010N. . . . ;t-IP+3GCf: rnr.n 7.0NIN 01 R-12
-L..RSS OF WORK— Nr-:W FLOOR rURN. . . , t EVpp cocl_EyR S:
TYrF- OF USE. . . . Sr-' UNIT 147ATER'a. . : VENT FANS—
OCCUPPNCY ("pl- :F'.y VENTS W/0 nrjr't_: VENT !ZYSTE"40:
)TORIES. , . . . BOTLCRS/COMPRESC"7175 HpL?F?S. r . . . , .
i. i"[71 0- 14P~ . , . . DOMCS. I hlf I i't;, �►
3-15 NF''. . . . [XIMML.. INCIN.
mnx INPUT% LTL; "c 1lp. . . . f;EPWR Uh.TT'.
FIRE: DAMPERS?. .. 30-SO O HP. . . WOODSTOVES% .
SC3t3F'tl ,0+ Hr', . . . , CLO iJI�'Yr'F"?„ ,
NO. OF UNITS---,_ . ... ..... A I I'2 HANDLING UW-r TO OTHER UNI Thi„
F=l.lRN! ! 10wil, '1_1 s 1.0000 (: Fm . ".;GAO C UTL-ET7ir
F"URN ?;---:1110K STU'c 10000 c'fm .
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CRNIE r--r r-RT `:;'_!vtt Fiy+ i ,,,.. i"wt_i•
SW I'dL1RT1'1 L7�,'.f1T(1 ^h*,'( t :Cir QI I JS)r) )Zc !19/95; 95-•-2.f
7S;) CA r' !3."T/^13 9� •' !1?!'70
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a S«@d subject tG th! rey:. i'•i T.1?y1JE!r^'1 tC1Tl
Muniripeil Code, �t�te of No. specialty '.ade-. and ;,:I! :`." f Ti�i i. 17,5,pry4b ion _....__.» �.._._.._._....,,._.__...»
1icable 16010 All WN-k .:,1; to d.wr
-'roved P104. 'Phis W-9it Will expire if wcr i:.
thin All days of iss•,ance, nr if kc-1-k )S s sf',. for
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City oi,Tigard MECHANICAL PERMIT PiancwRec. #
13125 sw Hall Blvd. APPLICATION Permit 4 ,wit=c -Iz . .
Tigard, OR 97223
(503) 639-4171
.,.a�-aam«�- sarr tion
Table 3.4 nlecftanical Code QTY PRICE AMT
Job (
•~ �� `) UCof 1) Permit Fee -0 -0- 10.00
Address
f �I) 1A �L ?, 2) Supplemental Permit 3.00
IG�A1' —
. ) -----Fumace
1) incl,duds 6 vents 6
Furnace I 00,OW 131 U+
? 2) incl.ducts 3 vents 7.50
Owner �I' -
Floor Fumance
_ 1"L
7 3) incl.vent 5.00 -
w uspe crater,w eater .r..
4) or floor mounted heater 6.00 _
.V ». —Ven nor in
Occupant 51 appliance permit 3.00
Repair of heating,re ng.
6) cooling,absorption unit 6.00
Boiler or comp,beat pump,air cond.
7) to 3 HP absorp unit to 100K BTU 6.00 _
� boiler or comp, a pump,air co
8) 3-15 HP absorp unit to 500K BTII 11.00
Contractor ti 11L�-.• �y i er or comp,heat p,air cond.
/ lr;-t(Lii ( l 9) 15-30 HP absorp unft.5.1 mil BTU 15.00
....o .. �rT�
90-401,or comp,heat pump,arr�-
';�, L_ �;)�( 10) 30-50 HP abso(p unit 1-1.75 mil BTU 22.50
hereby ac ow : •` •a ave rea iW
is app ica iTTon,tha ith — orw'�comp Tmp,air ca
information given .: n ti that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU - 3750
of the owner,that l;;cis a 0,nitted are in compliance with State it an wg ui To
laws,that I am rnJ th the Construction Contractors Board, 12) 10,000 CFM 4.50
that the number grv(,n is"rect. (If exempt from State registration, irTian ing u
please give reason below.) 13) 10,000 CTM+ 7.50
on portable -
14) evaporate cooler 4.50
-- --- e•!t fan connected
15) to a single duct 3.00
Ventilation system not —
16) included in appliance permit 4.50
---TTCFO s by
1 17) mechanical exhaust Y 4.50 T_
Describe worknow addition a teration repae ommar or industrial
to be done residential O non-residential O 18) type Incinerator
30.00
er
xis ng use of
_ Uthor 1.5,woodiEve.water
building or property 19) heater,solar,clothes dryers,etc. 4_50
Proposed use of 20) Gas piping ooejlQ lour outrits 2.W,
building or proporty r
21) More than 4-per outlet
Type of fuel -oil O natural gas t( LPG U electric 0 `--` _ ----
NOTICE
Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR S%SURCHARGE L `
IF CONSTRUCTION OR WORK IS SUSPENDED OR -- -
ABANDONED FOR A PERIOD OF 180 DAYS AT ANYTIME PLAN nIEVIEW 2S%OF SUBTOTAL
AFTER WORK IS COMMENCED.
Special Conditions
,- -- Date issued _by _-_----
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