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INSPECTION NOTICE
City of Tigoi I Building Department
P.v. Box 23397
Tigard, Oregon 97223
'hone: 639-4175
Type of Inspection _
Date RequestedL)— F Jr Time A.M. P.M.
Address ' `S� / ---- Permit t ?�
Owner�—=L' / / Lot # _
Builder
The following Building Code deficiencies are required to be corrected:
Presented to ?jpproved
Inspector Oisapproved
Pate
CALL FOR REINSPECTION
❑ YES ❑ NO
ME.`"HAWECAI 1-,E:PM:r, T
C17Y OF TIFA RD I'F*PMI:T NO. : ME882251
C
ITY OF TW
ARD DATE 11./1.n/Fie
COMMUNITN DEVELOPMENT DEPARTMENT OYEooH
l'WI:M. rwr .NO . 8822311.
13125 S W.Hall Blvd..P 0 Box 23397•Tigard,Oregon 97223.(503)639-4175
A1JUVIL'55 : 1.100:5 5W 70 T I I AVL
TAX MAP/I..O'T St JE;
I AND USIX .
11'EM. NO : NO:
WOPK GI-ASS : F-1,11-INAGE'. 0.00K A'1P 1-01401-14 0.0
FAMY.1 Y 100K.1- A-EW H6NDL.P 1.0K
CONS'T . FLOOP F 014NACEi. E:VAP -
OCIC"Llp . (.11114" . I-WA1,0:1 VENT 1---'AN
k1F.'N'T VEN'T' SYSTE-.'M
BLJ1/(',OMP <31-1P HODD
NO S4014I.E.KS : 3:N(:,:ENL-.:PA*T'OW(I.)OM
DWIFI.J.- UNTTS : 81 P/(.,(]Mf,' 1,P5 30HP 1WXNEPATUP(COM
114:1'. I D I P/C01,41-, "f'0---'50I-4P WLPATH UNITS
HAX . 1:1,441y, I-N.-RO"GOMP 50+I-IP 04'HER
I.-IJAK I)MPPil? (3AS PIP-.EN(., OUTLETS
1_(:1W V44F.C"',
W1 NCHF: i I STAN PE:PM11, 1101 00
0 UW /811-1 AVF. i,l P.N Rl�:VTKW
W
N I 3112,AWD 0 A 9 r 12 ri'� i 111.1 . .`10
E I::'HO1W (,503) 611314-6!51.0 1,L..", 1,A X $
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PF'U'UP'T NO.
..........
This permit is Issued subject V�the regulations contained In Title 14 W 1:CA t JT,p F.:rJ
of the TMC. State of Cireger Specialty Codes,zoning regulations
F TNAL
and all other applicable cedes and ordinances, and it is hereby
agi-eed that the work will be done in accordance with the plans and
specifications and In compliance with all applicable codes and
ordinances Thp issuance of this permit does not waive restrictive
covenants Con rector and subcontractors shall have current city
business tax pe-mits This permit will expire and become 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 trApections are requested and approved
"ermiltee Signal u r
:,rll. I Or"
Issued By
SEPARATE PERMITS REQUIRED FOS' WORK OTHER THAN DESCRIBED ABOVE
tltA ell► t■9 Ilir � teR 6Ar I� t�
ILA I Y Vt" I IUAKU MECHANICAL PERMIT Permit fY (i Zz __-
Description
Table 3A Mechaoical Coda CITY PRICE AUT
City of Tigard 1Permit Fee —�-- 0 -0- 10.00
13125 S.W. Hall Blvd. _) _.- —_-.---_-__--P.O. fro'.( 23397 —2) Supplemental Permit 3.00
Tigard, C R 97223 _._
639 41751) Furnace to 100,000 BTU 6.00
incl.ducts 8 vents
2) Furnace 100,000 BTU + 7.50
incl.ducts&vents
Name of Development 3) Floor Furnace
Development —--— 6.00
incl.vent _ _
Suspended heater,wall heater
Joo Addressr�, -7� r -1764(u)O 4) or_-floor mounted heater 6.00
Address /��?j _
Tar Lot Map No a 5) Vent not incl.in 3.1210
Lot Block Suwlvlslon _ appliai ice permit ---- --` -
Name(or name of business) 6) Repair of heating,refrig., li 00
-3--rAA,1 j�J/n,� 1/�+S-f�2, cooling,absorptior unit
Mailing Address Phone 7) Boiler or comp to 3 HP 600
Owner ��^�� ����_fir/ absorp.unit to 100,000 BTU
City/swwre Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
NameBoiler or comp 15.30 HP 15.W,
9) absorp.unit 1/7-1 million
Mat"Addr phone 10) Boiler or comp to 30 50 HP 22.50
absorp.unit 1 -1.75 million _ _
Contractor City/Stale ZIP 11) Boiler or romp to 50 HP 31.50
absorp.unit 1,750,000 BTU
State Registration No. — City Bus Tax No t 2) Air handling unit to 4.50
10,000 CFM
13) A r handling unit —� 7.50
1 hereby acknowledge that I have read this application that the information given Is 1 jOO CF +
rprro^t,that I am the owner or authorized agerd of the owner,that plans submitted are in - ---
compliance with Stale laws,that I am registered with the State Builders'Board,that the t 4 Non portable 4.50
number given is ocrrect.(11 exempt from Stale registration please give reason befowl ) evaporate cooler
- e5�14 PT-l4 5 �1u 15) Vent fan connected 3.00
to a single duct
- 16) Ventilation system not 4.50
included in appliance permit
17) Hood served by 4.50
mechanical exhaLlst _
Signature(owner or agent) tlai 18) Domestic type 7.50
Describe work FJ addition ❑ alteration Fl repair l-] incinerator — _to be done residential ❑ non-residential I l 19) Commercial or Industrial 30.00
Existing use o1 _ type incinerator _._
building or properly_ 20) Other i e.,woodstove,water 4.50
heater,solar,clothes dryers,etc.
Proposed use ul — _� ---
building
_building or property •. 21) Gas piping one to four outlets 2.00
Type of fuel- oil Fl natural gas F1 LPO ❑ electric F1 )
22) More than 4-per outlet
NOTICE e `~ SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON. ---- — —'
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ -. _- S°1006SURCHARQE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SL113-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -
WORK IS COMMENCED TOTAL
Special Conditions
I,1,r.-11od by
INSPECTION NOTICE
City of Tyard Building Departrr,ent
P.O. Box 23397
Tigard, Oregon 97223
P•lone: 63c9--4175
Type of Inspection
Date Requested_ __/�� y _ Time A.M._ P.M. G
Address Permit
Owner / / �� / Lot #
Builder � C �" ,.QSLp1 — G2 R—
The following lluilding Code deficiencies a-a required to be corrected:
`I �../� 1�►�J .%1 `tet'/(,r._ _Q7� � _—.
Presented to4-,--2j Approved
Inspector �C1 11*pp►oved
Date
CALL FOR REINSPECTION
'YE i ❑ No
W WNW W W
MECHANICAL
PEPM1 T' NO . : tff!'1-30:1.9,elel
CITYOFTIGARD Cny ra
COMMUNITY DEVELOPMENT DEPARTMENT MOON 3 0/EIS
13125 S.W.Hall Blvd-RO Box 23397,Tigard.Oregon 97223,(503)639-4175 Jn'M-J- .NO .
ADDPESS : 1:11.085 SW '7011-11 AVE
MAP/LOT SUB :
IANC) USE :
I-01 GIZE:
11'EM: NO: NG:
WURK CLASS : ALTE-11RATION F0141NACE <100K AIR HANDL.P <10
tJ514- TYPE: S:I:NCL.I:-- F=AMILY l:;'UANAC1'-: 1001(+ AIR HANDLW 10K
CONSI . ["LOCIP FUlPINACE EVAP.C001-1-P
OCCUP , 1.4EA11:14 VEN T' FAN
VENT V U':li . SYS TEM
OLP/COMP (3HP HOOD
NO . 5*T'(:)WIr-*.Si : INCINEPA'TOR(DOM
DWELL- IJNI,rs . ]:NL,:I.*NE*r-4A TOP(COM
FUEL *)'YF)E 131 WCOMP 30 30HP Pl:;:P(-)IP LINTIS
MAX . INPUT Bl-W/COMP 304-HP ()I'Hl:;:Il I
(3A5r--')*P1'NG, OUTLETS
1...(:)W
REN11:34
Pl*-"MARKS
WINCHESTER 684-63if)
W(:)(:)I)s'row-:-
P'EES :
0 M,1:K F., PEPM1'T'
N
W 1-13690 SW V.1,NCr-.:N'T
PLAN REVIA-.W
E ALOHA OR
R 11111 4. 50
YT'ATE. I'AX
0 FHE 14
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166C ,
AF:CETI'-'1' NO,
This permit is issued subject to the regulations contained in Title 14
of tl-n TMC. State of Cliegon Specialty Codes,zoning regulations :AKQ1J1:R1A) TNSPF("-'T'1ONS
and 811 other applicable codes and ordinances. and It is hereby
agreed that the work will be done in accordance with the plans and
specitication4 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 become null and
void it 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 permitter.to assure
all required inspections are requested and approved
,e
'tt Signature
ure
Issued By LCT.Tot4 639-41 in
SEPARATF: PERMITS REQUIRED FOR WORK OTHER THAN DESC931BED ABOVE
!� Wr` _�` !�y" ♦WXWq 11iu��^a'�f.'� ep MAI yU'�®,a��`a� yh�QPERMIT
,�uwe '`ems
V' ■ U i- I I M r-■ ■�/ ■�f LIG• /��T■ 7 I C A L ��E R.7.I Y
Permit p
Description
Table 7A
City of TigardMechanical Code, CITY PRICE AMT
------------- ---_ --
13125 S.W. Hail Blvd. 1) Permit Fee 0` -0- 10.00
P.O. Box 23397 — _-- - – -
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175
to 100,000 BTU
1) incl.ducts&vents 6.00
2) Furnace 100,000 BTtJ 1 ^�
incl.ducts R vents 7.50
Name of Development ;Floor Furnace -
L !c/ 7,E 1'4 --� incl vent- - ---- ------ 6.00
Job Address 4) Suspended heater,wall boater
Address 7 ,�� 0 fes. or floor mounted heater 6.00
Tax Lot Map No. -- 5) Vent not incl.in
—Lot Block Subdivision appliance permit 3.00
Name(or we of business) — 6) Repair of heating,refr ig.
cooling absorption unit -__ 6.00
Owner Mailing Address Phone 7) Boiler or camp to 3 HP
-7p e,, / absorp.unit to 100,000 BTU 6.00
City/State Zip8) Boiler or comp to 3 HP-15 HP
absorp.unit to 500,000 BTU 11.00
Name Boiler or tromp 15-30 HIP
� 91 absorp.unit 1/7-1 million 15.00
Mailing Address pno„a 10) Boiler or comp to 30-50 HP
Contractor S Z �! �t- A CW.fr s�it absorp.unit 1-1.75 million 22 50
Ci ylSlats 71p 11) Boiler or comp to 50'4P
absorp.unit 1,750,000 BTU - 31.50
State Registration No Cly Bus.Tax No t2) Air handling unit to
_ 10,000 CFM 4 50
I hereby achnowledoe that I hale read this application that the information given is 13) Air handling unit - -
correct,that I am the owner or authorized agent of the owner,that puns submitted are in 10,000 ChM t 7 Sn
compliance with State laws,that I am registered with the State 8uildnrs'Bard,that the1d) evaporate cooler
Non portable
number given is correct.(if exempt from State registration please give reason below). 4.50
- 15) Vent fan connected
to a single duct 3.00
16) Ventilation system not
—
included in appliance permit 4.5n
J `- 17) Hood served by
mechanicalexhouct 4.50
Signature jowner or agent) ----
Date 18) Domestic type
Describe work ❑ addition Cl :flteration [] repair [a _ incinerator 7.50
rbuilding
done residential L3 _non-residential f7 _ Commercial or industrial
ing use of
-- - 19) type incinerator 30.00
ng or properly Other I.e.,woodstove,water
osed use of
----� - - 20) heater,spier,clpthtts dryers,etc. 4.50
or property_ — -` -- --
Type of fuel- oil Cl natural gas (_7 LPG 1-1 electric [ ) 21) Gas piping on j to tour outlets 2.00
22) More than 4-per outlot
NOTICE
THIS PERMIT BECGME3 Ni-':.L AND VOID IF WORK OR CON. SUB-TOTAL
RUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 St10 406 SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR -
ABANDONED FOR A PERIOD OF 160 DAYS AT ANY TIME AFTER PLAN REVIEW 2556 OF SUB-T JTAL
WORK IS COMMENCED TOTAL
Special Cunditions �-
- Date issued by
�kyr ��
� Gov
v ,� �� i.
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