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INSPECTION NOTICE
City of Tigard Building Department
1325 SM Ball Blvd. TiSard, Oregon 97223
Inspection Line (Hen-O_Phone): 639-_4175 Business Phone: 639-4171
Inspection: ---
Footing Plbg. Underslab Mech. Rough-Ln Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Pont/Beam Struct. San. Sewer Frami ���_Plumb.
ldq.Pont/Beam Mach. Rain Drain Insulat
Plbg. Underfloorn g ater i 6 Gyp. Bd. ^ 7>U // eph.
Date Requested• —Time ---PM
Address: Z L ` Permit f:�/� L
Builder:
TEE FOLLOWING CORR£ NS ARE REQUIRED: y SIJ / GCT 3 Q�
Inspaetors__ �1--� _- Dates 6— G'6- -,9 ;L—
APPROVED
APPROVED DISAPPROVED APPROVED BUBJNCT TO ABOVE
Call For Relnep.
CITY OF TI
GARD cn :- go
m MECHi 4N i GAL
COMMUNITY DEVELOPMENT DEPARTMENT after* PEPMIT
13126 SW HWI B6-d.P.O.Box 23397,TOM,Oregon 97223(603)639-4176 D F R M T T' #. . . . . . .
SITE ADDRESS. . . a 11433 SW 66TH PARCEL:
SULIDIk."ISION. . . . ZONING:
BLOCK. . . . . . . . . . . LOT.. . . . . . . . . .
CLASS OF WORK. . :ADD FLOOR FORK. . . . : EVAP COOLERS:
TYPE 017 USE:. . . . :GF 'J!qIT H1=_ATE'RS. VENT F(ANS. . . .
OC UUPANCY GRP. . :R3 VENTS W/O APDL.: VENT SYSTEMS:
STnRIEFS. . , . . . . - BOILERS/CONPRESSORS HOODS. . . . . . . .
rUL-:.L TYPES—-----— 0-3 HP. . . . . 1 DOMES. INC111J.-
- /ELE/ 3-15 - COMML. I1,4CIN-
MAX INPUT: BTU 15-aO HP. . . . REPAIR UNITS:
CITPE -. '30--'Jo HP. . . . WOODSTOVEG. . -,
SPS PRESSURE. . . 50+ HP. . . . CLO DRYERS;. . *
!40. OF F'ITR HANDLINC-3 UNITS OTHER UNITS.
,-UHN ( 10LAK BTU: 10000 cfm: GAS OWLETS.
:URN DFU., 10000 rfm:
Uwner: FEE'S
JOHN BURR17-'_ type a m P'."l t by date
11433 SW 661H PRmr $ 25. 00 JLH 06/04/92
I'lGARD OR 5PC,T $ 1 . 25 JLH 106/04,
'-1110t1v #.
L'otittact or:
140BBEN 1414D 50141", HEATING
_11300 SE, 7TH AVE
-.8. 0. 1:0X 14G E,'/
.10PTLAND OR 97814
,hone
-'eq #. . - 01884
------- RE CK]I RED INSPECTIONS
'his pet-nit is issued subJect to the rtaulations contained in the Final ITISWectivil
i9ard Municipal Code, State of Ore. ;oeclalty Codes and all cthev-
i0t)hcablt laws. All work wili he dune in accordance with
Approved plans, 'his Downit will expire, if work is not stared
.ithir 160 days of issuance, or if work is suspended for sort
!han 180 dam
rrtni'ktae+
Call fnt- jrlspec'tion
71TY OF TT.GARDMECHANICAL PERMIT Reccipt #
312 5 'S T,4 I IAI.L BLVD- Permit #
O. BOX 2339'7
�� 1 poscription
I G 11RD, OR97223 'T)(+ (rI V Table'sA Mechanical Code _ t]TY PRICE AMT
503)639-4175 i 6-I 1 D 1)_Permit Fee -0- -0- 10.00
Naffw of Deve1w, 2) Supplemental Permit 3.00
Job �� t 1 Furnace to 100,000 BTU 6.00
Address ZI / incl.ducts&vents
Tax Lot map NO. 2) Furnace 100,000 BTU + 7.50
Incl.ducts&vents
I ct Rlock Strttdivisiort —
n ame(or faf,e of txr..ir,ess) - 3) Floor Furnace
incl.vent
Ph" Suspended heater,wall heater 6
4) or floor mounted heater
� ��„ zip 5 Vent not incl.in,ft3.00
,co! ' �1 9 •�-,��� _) appliance permit
Name name of Hess) 6) Repair of heating,refr ig.,
Cooling,absorption unit
Mailing Mdrass Phone - 7) Doiler or comp to 3 HP J J? C / 6.00
Occupant absorp.unit to 100,000 BTU 4 l
CnYhState — - zip 6) Boiler or comp to 3 HP-15 HP„ A C 11.00
absorp.unit to 5U0,000 BTU
N - 9,I Boiler or comp 15-30 HP + A C 15.00
0-y absorp.unit 1h-1 million
Boiler or comp to 30-50 HP A C 2.2.50
r �riw gAddre�s /y v� / / 10 absorp.unit 1-1.75 million
Contractor rV1)/ k/JC o 23P33 11 Boiler or comp to 50 HP 1- 31.50
absorp.unit 1,750,000 BTU
State PAqjsm No City Bus.Tax No. 12) Air handling unit to 4.50
10,000 CFM
U //n n�- Air handling unit 7.50
I hereby ad nowiedhe dW I have road this apo ation thal the"ormabW given is 13) 10,000 CFM +
oorrect,that I am the owner or auttrxiuod agent of Moe owner,that plans sudrtitled are in
coff"arre with State laws,that 1 am registerod with the State nuikiers'[bard.that the 14) Nen portable 450
number elven is coned.(tf exempt horn Stale registrat"i please give reason below). evaporate Cooler
15) Vent fan c.,nneded 3.0(;
to a single dud
-- -� - --. -- --------.--- Ventilation system not
+ 7 16) 4.50
included in appliance permit17)
Hood served by 4.50
W- mel L _mechanical exhaust _—
tre(--or agent) — Date 18) Domestic type 7.50
Describe work ❑ addition l; alteration ❑ repair ❑ incinerator -F
to be done residential ❑ non-residential ❑ t 9) Commercial or industrial 3000
type incinerator
Ehlsting use of - -
Olher i.e.,woodstove,water
twiWirg or properly_ __ 20) 4.50
heater,solar,clothes dryers,etc.
Proposed use of
building or propetty — ---- 21) Gas piping one to lour outlets 2.00
Type of fuel- nil ❑ natural gas ❑ LPG ❑ electric Cl
--- - 22.) More than 4-per outlet
NOTICE SUB-TOTAL
HIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- —� - �`
STRUCTION AUTHORIZED IS NOI- COMMENCED WITHIN 130 -, 5%SURCHARGE _ Yo
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
AWWOONED FOR A PERIOD OF 1130 DAYS AT ANY TIME AFTFR -- - - -`
WORK IS COMMENCED. _ / TOTAL
pe
Scial Conditions -_. //1 L�
V� 1
Dole issued by