11810 SW 72ND AVENUE .. ......__........... _. ..............-...._._.w,...."..-........ .. _.. .. win..
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11810 SW 72ND AVENUE
INSP!.PION NOTICE
City of Tigard Building Department
13125 Bit Ball Blvd. Tigard, Oregon 97223 '
Inspection Line I(Rec-O-Phones 639-4175 Business Phone: 639-4171
Inspection:__— "( '��. —f
Footing P).bg. inderalab Mech. Rough-1n Appr/Sdwlk
Found. Mg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. -;ewer Framin(I -Bldg.
Post/Ream Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water ine// Gyp. Bd. -Meeh. ,
Date Req.seste:+s_ ___ Times AM PM
llddresn Permit
Res 1 1 der: —�—_--
TRP.' Fi)Ljc ZING CORRECTIONS ARE REQUIRED:
a ^4z
inspectors nates__
APPROVED DISAPPROVED APPROVED SU&MC1' TO ABOVE
tall For Aelnep.
CITYOFTIFARD
C[TYOf ilGAM I ECHAN I CAL
COMMUNI IY DEVELOPMENT :DEPARTMENT omrmooe, PERMIT
13126 SWHidlBlvd. F.0.btm23397.Tigird,0rpon 97223 (603)8344175 PERMIT #. . . . . . . . MEC 92-0233
639--4171 DATE ISSUED: 09/15/92
SITE ADDRESS. . . : 11810 SW 72ND AV PARCEL: 1S136DC-03501
5UBD I V I S I ON. . . . : El-NOLA HEIGHTS ZONING: R-3. 5
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 11
---------------------------------------------------------
ULASS�OF WORK. . :ADD FLOOR FURN. . . . : EVAP COOLERS r
TYPE- OF USE. . . . :5= UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP. . :R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES. . . . . . . . cl BOILERS/COMPRESSORS HOODS. . . . . . . :
FUEL TYPES------------ 0-3 HP. . . . : DOMES. INCIN:
:/WOD/ / / 3-15 HP. . . . : COMML. INCIN:
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
F RE DAMPERS?. . : 30-50 HP. . . . -. WOODSTOVES. . : 1
GAS PRESSURE. . . : 5a1+ HF.. . . . : CLO DRYERS. . :
NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. :
FURN ( 100K BTU: i= 10000 cfm: GAS OUTLETS. :
FURN )=100K BTU: > 10000 cfm:
Remarks: FREESTANDING WOODSTOVE
Owner: ------------------------------------ _.____•----._______ FEES
.JUHN CONNEIr type amount by date rec:pt
11810 SW 72ND AVE PRMT $ 25. 00 JH 09/15/92 -
SPCT $ 1. 25 JH 09/ 15/92 -
I I UARD OR 97223
Whone 0:
Lontractor: -- - ------__....___—_------__—___._
OWNER
_._-----....-.--_-----------------------_
Pti o n e #: 26. 25 TOTAL
11etj 00000
- -- REQUIRED INSPECTIONS ------
This permit is issued suhject to the regulations contained in the final Inspection
ligArd Municipal Lode, State of rDre. Specialty Codes and all other
applicable laws. All work will to done 1n accordance with
approved plans. This permit viii expire if work is not ,tarted
within iW days of issuance, or if work is suspended tar more
than JW days.
e r,m i t t e e
I ; c 1.1ed By:
Call tor- inspection - 639-4175
-g Permit No: P _3
Address: 11�-/U
Issued by: Date:
a FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4) , requires residential constructioii permit
applicants who are not registered with the Construction Contractors Board to
sign the following statement before the building permit can be issued. This state-
ment is required for residential building, electrical, mechanical, and plumbing
permits. Licensed Architect and Engineer applicants, exempt from registration
under ORS 701.010(7), need not submit this statement. This statement will be
tiled with the permit.
Fill i( he applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B:
1 . I own, reside in, or will reside in the completed F''ructure.
2. r l 1 understand that I must register as a construc,i,D,i contractor if the structure is sold
or offered for sale before or upon completion.
3. A.I I My general contractor is _ - _ _ _ - _- .
Contractor registration number
will instruct my general contractor that all subcontractors who work on the stru,;-
ture must be registered with the Construction Contractors Board.
OR
3. B. i! I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. If I change my mind and do hire a general contractor, I will
contract with a contractor who is registered with the Construction Contractors r1oard
and I will immediately notify the office issuing this building permit of the name of
the contractor.
I hereby certify that the above information is correct and that I have read and understand
the Information Notice to Pi aperty Owners about Construction Responsibilities on the
reverca side of this forth.
Sig B o POITIfiff Al5pIlEant 55te
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
CITY OF TIGARD RFCFIPT OF PAY011-7,14T RFCrIPT' NO. 2 92-P 3 1 C.3.2-
NAME : CONNET, JOHN CHECK AMOUNT : 2-16. 215
ADDRESS : 8416 SW 57TH (ST CAB'H AMOUNT 0. 00
PAYMENT DATE
PORTLAND, OR 97; SUBDIVISION
PURPOSE. OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
MECHANICAL
25. 00 ST. BUILD PER 25
WOODSTOVE PERMIT
11610 FlW 7i CNV AVE"
TOTAL AMOUNT P01r) 26. 25