10500 SW 71ST AVENUE-1 i
ADDRESS:
106000 SW IISTAVF.NUF...
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CITY OF TIGARD BUILDING I PECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -P u b.
Post/Beam Mach. Shear/Sheath Framing -Mach.
Plbg.Und/Fir/Slab PIbg, To Out Insulation -Elect.
Post/Beam Struct. Mach. Rough- Gyp. Bd. -Bldg.
San. Sewer as�� Appr/Sdwlk Reins.
-��Other:
Date: A.M. A P.M.�.� Ent
Address: _5 U U ��,(..�C. _..%
Tenant: Ste: _ MST: _
Con/ v0: 501` C7 BUP: —
MEC:
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
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tol i Date:
4cPROVED
_DISAPPHOVEDICALL FOR REINSP, CF CO
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171
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CITY OF TIGARD Mechanical Permit Application Recd By
13125 S11V HALL BLVD. Commercial and Residential Date Recd?z•1 7-97
TIGARD, OR 97223 Date to P E
(503) 639-4171, x304 Date to DST
Print or Type Permit# Mil'ca_ 1a3
Incomplete or illegible applications will not be accepted Called
ame of DevelopmdntiProlect �t Description
00 1451W. Table 1A Mechanical Code OTY PRICE AMT
.lob Street Address + Suiteft A) Permit Fee -0- 0- 10.00
Address '-
wagotylstate Zip 7 B) Supplemental Permit 3.00
C
Q� �O�
Name for name of Cusiness) 1 ) Furnace to 100,000 BTU 6.00
Owner be�-,qt�e'l h incl.duds&vents
Marling Addr ss 2.) Furnace 100,000 BTU+ 7.50
�%v I incl.ducts 6 vents
iStatee�LA p zip Phone 3) Floor Furnace 6.00
���✓ o • 3 -/Sc1 incl.vent 1
NU (or name or business) 4) Sespenuerd heater,wall heater 6.00
(� 1 G�� or floor mounted heater
Occupant Mailing`tldr ss f� 5.) vent not incl.In
3.00
appliance permit
CR i,State zip Phone 6.) Boller or comp,heat pump,air Gond. 6.00
) pe at q C�3 '�>� I _ to 3 HP;absorp unit to 100K BTL_I
N ( 7.) Boller or comp,heat pump,air co id. 11.00
f {k "' I ( 3-15 HP:absorp,unit to 500K BTU
Contractor Meitoia Address 8.) Boller or comp,heat pump,air Gond. 15.00
(Prior to CityfSCtpJts A 15-30 HP;absorp unit.5-1 mil BTU
Z.P hone 9.) Boiler or comp,heat pump,air Gond. 22.50
issuance a copy W' cc TOW � r- a� 30.50 HP;absorp unit 1-1.75 mil BTU
of all licenses are Oregon Const.C9nI.Board uc a Exp.Date105
Boiler or comp,heat pump,air Gond. 37.50
required # - 50 HP;absorp unit 1.75 mil BTU
expired in C.O T 1-07 Business Tax or Maud# Exp.Dine 11.) Air handling unit to 4.50
data ha.se) - 10,000 CFM
Architect Name 12.) Air handling unit 7,50
10,000 CTM
Or Mailing Address 13.) Non portable 4.50
evaporate cooler
Engineer c tylstate zip Phone 14.) vent fan connected 3.00
to a single duct
Describe work New O Addition O Alteration O Repair O 1.5) Ventilat-cn system not 4.50
to be done Residential 8Non-residential O included in appliance permit
Additional Description of work 16.) Hood served by mechanical exhaust 4.50
f17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrialtype 30.00
budding or property incinerator
19) Repair units 4.50
Proposed use of 20) Woodstove 4.50
building or property_
21) Clothes dryer,etc. 450
Type of fuel-oil O naturalgasA LPG O electric O 22) Other units 4.50
I hereby acknowledge that I have read this application,that the 23) Gas piping onn to four outlets 2.00
information given is correct.that I am the owner or authonznd agent of
the owner,that plans submitted are in compliance with OreState 24) More than 4-per outlet (each) .50
law gon►� - C 3-xT
Signature of Owner/Agent /'Date QTY.sUBTOTAL
'SUBTOTAL
on Name Phone 5%SURCHARGE S
/ PLAN REVIEW 25%OF SUBTOTAL
TOTAL
i idstVnechpmt.doc (rev 7196) "Minimum permit fee is 325+5%e_-nharge