16655 SW QUEEN MARY AVENUE ADDRESS:
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Brecords\microflm\targets\building.doc
INSPCCTION NOTICE
City of Tigard Building Department
13125 Silt Ball Blvd_ Tigard, Oregon 97223
Inspection Gine (Rec-0-Phnne): 639-4175 Business Phone: 639-4171
Inspection:
Footing Plbg. Underniab Hoch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out /Oae Lige
Poet/Beam Struct. San. Sewer l Framing -Bldg.
Poet/Beam Mech. Rain Drrin Insulael.on -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. --� �►"� •i
Date Requested: 15-/0 `/ T �AM PM
l� L S Dae-f.,/ /jk2. z cI P n�fr.
AddrPsa! D /� ' � Z-
Builder S L� / 3�/�
THE FOLLOWING CORRECTION ARE REQUIRED:
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Inspector:- \% j�1 0✓ nat.a:_�_..._^
APPROVED DISAPPROVED ✓ APPROVED SUBJECT TO ABOVE
VQ j� --_Call For Reinsp.
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839.4171
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City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Nati Blvd. APPLICATION Permit #
Tigard, OR 97223
(603) 639-4171
Table 3A Mechanical Code QTY PRICE AMT
Job „• 1) Permit loo -0- -0 10.00
Address
n (-A kl ciz Cf7a;:)4 2) Supplemental Permit 3.00
urr.ace to 100,000
1) incl ducts&vents 6.00
� i urrace 100,000 +
Owner N� 2) incl.ducts a vents 7.50
oor urnance
3) incl.vent 6.00
-- .m. ., • ••• SuspendTheater,w eater
4) or floor mounted heater _6.00
a Vent not incl.in
Occupant 5) appliance permit 3.00
am. Repair of hearing,re ng.
6) cooling,absorption unit 6.00
---- - �� Boiler or cc.n7PTeat pump,air condi
[ 7) to 3 HP absorp unit to 100K BTU 600
.+ro ••• iter or comp, eat pump,air cond.
PC, /.( , 8) 3.15 HP absorp unit to 500K BTU 11.00
Contractor Boiler or comp,Feat pump,au cond.
el- (L G1 "� ,= z 9) 15-30 HP absorp unit.5.1 mil BTU 15.00
3�. ...—No. Boiler or comp,heat pump,air K d
C1 -I l_. fY`i J -;) �^� 10) 30-50 HP absorp unit 1.1.75 mil BTU
re y acknowlcH Ige that I have read this application,that the Boiler or comp,heat pump,air con .
in`urmation given is correct,that I am the owner or-Ahorized agent 11) >50 HP absorp unit 1.75 mil BTU 31.50
of the owner,that plans submitted are in compliance with State Air handling unit to
laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air handling unit
please give reason below.) 13) 10,000 CTM+ 7.50
"-"— Non portable
14) evaporate cooler 4.50
Vent tan connecteT-
15) to a single dud 3.00
Ventilation system not
16) included in appliance permit 4.50
�««:,, ••
-----Pood served y
17) mechanical exhaust 4.50
escnbn work new acIdition alteration repair 0 Commercial or industrial
to')e done residential Qr non residential Q 18) type incinerator 30.00
7ztsting use of Other i.e.,wob7stovo,water
br ikfing or property_ 19) heater,solar,clothes dryers,etc. 4.50
Proposed use of 2C) Gas piping one to lour outlets 2.00 _-).C)0
building or property -
21) Morl,Dian 4-per outlet
Type of fuel-oil Q natural gas l® LPG O electric O — —
t C)0
G c
Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK On CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSP17NDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED. --
TOTAL
Special Conditions
---- ------
Date issued by
►«MccrrvMT
r I TY (lf I I C;Apl) - PVC.F.I FIT OV PAYMENT* PE Cf-U'T' NO. „9.: x'381347
CHECK AMOUNT a �1.6. 125
NAME : �;l1NAE"C f=Uf l_. ( �1 CA)H AMOUNT 0. 00
NAMftf.C��; F''C1 SETC)X 4�'FL. PAYMENT 1JATE::: 0409/93
;I.jSDIVISlON
F,os-CI...AND, OR
Pl.Jf2F'lJ'if (')r F''AYMf=:N'T' AMOUNT F'A 11"� F?1.1F7F'(JciE. OF- PAYMENT AMC1l1PJT PAID
14EGWFaN'F.C;f1l. f'[; r::...,. 00
ST. E►Ull.l) PER
16655 f3W Ul f:`f N MARY, F!INI-,i Ci 'C
TOT AL. AMOUNT' V'A 11)
O"T-24—'90 WED 14:54 ID:PURKEYS TAX SEP.UICE TEL NO:= 684-81(ZE :276 P02/03
KING CITY
15300 SW. 116'h k%muw,V.,ng City.0r:-gon 9-,''^J Phone;639•J051
CORIJUNITY DEVELOPMENT
A.??LICATION FOR BUILDING ?EMIT
(1:struetions at revtrae)
DATF �- C 1
I. NAME OF APPLTOANT; `� C:e 1G�.�C� ��.�� - Phone No.Ly C= -
ADDR?SS: L ` 1-�
ADDR$SS (V PROPOS= IMPRC7V' MIT _
2. TYPE W CYANCE, LMPROV=r OR CG:I STRDC;I VN FOR WH i C--i P.EMM I T IS R-7Qr-7ES 7M.
DF-Sr.RIBE BRIFEIFLY -,A7rPCi 7r40 C-DPIES OF PLANS OR DRATqINGS OF
PPOPOS= PROJE :
.1
3. NAME AND ADDRESS OF CO-,.-,RAC-MR `��� "1`�� '� --� `-�•. _C_ �1W�
I--iot E 110 1 LI=4SE NO, 0'1-'1 1.-'1L
4 . NEI(--MRS WHO MAY BE AFFz'CT�''J BY THIS PRO,= WILL SE NOTIFIED BY nla CITY.
5. APPLICANT OR �=/HIS �r�Sz:rTATIVE MUST BE PRESe^_4^ AT iriE PLANNINCa ca-4-SISSI0:4
KEETING NTXT EE—LD ON 1
REPRESENTATIVES NAME_ eriONE NO.
(;he ring Citf ?la:ninq Cor,tissicn vill consider onll tl,cse ilplica::cis recei-ed at least !ire (S) dols
prior to a tteting,)
SIGNATURE R
APPLICATION RZC-r.I VED 5Y `- --
APPLICABLE F;-T RECr_IVEO S ,2S ` %-Yru
PLsV4NING 0 V%;, 4N 'ISIVN: APpcav- Nazi_
CONDITIONS 7 r J - J
Appr Vd app'Iications are valid for iz ; bs 41f
Date 's-�-Cly
XOTI:: Orem lottbuiiders Lar requires tbat all persons via contract for vorf an their residence be
registered lith the Builders Board vhich tilts the contractor is banded and 'insured on the lob site.
for Icor protection, bt certain four contractor is reaister�d hf calling Citi lall Ph: 615.011,
rIOTc: A permit must also he obtained frcm the City of Tigard Department of
Canmr ity Development Yp-q No
=CF TIG=_JJNS?H=1 4 R—FORT
he above listed project hrs been in-tpected and Approved_ - _-___Denied
Date_ Cctmv—ants
.signature
(P.0 i.P..dt:tg ui.5 pe t-co, pLe a u— Az tui t orte. ( 1) ca p y do K-u C U-y)
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