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13020 SW PACIFIC HIGHWAY 13020 SW PACIFIC HIGHWAY I x R a 3 v C I INSPECTION NOTICE I, City of Tigard Building Department /( P.O. Box 23397 Tigard, Oregon 97223 / /Phone: 639-4175 Type of inspection ..rt aJlj . Date Requested �`- /1 ' ! Time A.M. Address 1 ✓0 �� �u`� Permit # Owner __.._ Lot #� Builder The following Building Code deficiencies are required to be corrected: Are - Presented to +H�-Approved Inspector —--T — �J Disapproved Date - CALL FOR REINSPLCTION ❑ YES IJ NO 77' I1I'.KGI-1AN'I.*C At PE-JIM3.1' CITY ' F T'VA RD PE"Pl"I'L'T' NO MF89:I.H86 t CrTYOFr"10 COMMUNITY DEVELOPMENT DEPARTMENT 13121,S.W.Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223.(503)639-4175 DAI'F.;' T.SSUFA): Y/ 6/89 PW I M. PMT .NQ —44414144W6 JOB ADDAF-SS : I30PO 15W PACIFIC HWY TAX MAP/LO'T SUB: UK : LAND USE: : OT r-.):I:ZE: : I T*EM: NO: NO: WORK CLASS : Al TEPA11ON FLJPNACE <100Y, AIR HANUL14 <10 USE': TYPE: SIN(A E 1::'AMI.LY FUPNACE 100K+ t ATFL HANDLR 10K CONST' . 'T'YPE-K: 11-000 F:UPNACE E:VAP.COOLEP OC(A.W . GAp. HEATEW VEN'r FAN V I N'T VEI N'T . l;Y S I*r--'M HILWCOMP "3?iP HOOD NO . 51'ORIES : BI-P/COMP 3-1151--lP INCINEPATUR(DOM DWIELL -UNI'T'S : BI.-PiCtIMP 15---30HF** INC INr--'I.IA*r(JP(COM 'TYPE: BIJI/COMP 30-501-4, PEPAIP UNJ."T'S MAX . INPUT BIL.P/COMP 30+HP 0114EP I=:I DMPI-157 GAS PIPING OUTLETS J. HIGIA PPEISS-7 ('111-) PWLIL67 1:1.01*11 btu ' % 0 FEKES W am 1.t 1-1 pat-riv.ia PF-PM'.[*T* $ 11.0 00 N IL319,,,3 11;W 1r.,.21Mt E 1--)I-.AN PEVIEW R ti(.4 a r cI ar 97R23 FIX'TUAES $9 . 0 51 ATE" TAX 4; . 19H 01+11--p C 0 N T AAA l+T*NG. AND COOI ING R 2 A 91.5 NE UNION AVE. C Partlarid OP 9'7212 T O 20-1-2173 R I 1111�EGIG'TAATIDN NO. 22,.? TOTAL : 1111EW . 414 This permit is Issued subject to the regulations contained in Title 14 PKIDLIPT N0. ffi of the TMC. State of Oregon Specialty Codes,zoning regulations and all other applicable codes and ordinances, and it is hereby PE'Q( IPF.r.) INSPEE-TIONS agreed that the work will be done in accordance with the plans and GAS L.I:Nl:-- specifications and In compliance with all applicable codes and ordinances The issuance of this permit does not waive restrictive covenants Contractor and subcontractors shall have current city business tax permits This permit will expire and become null and, FINAL_ void If work is not started Within 180 days,or If work is suspended or abandoned for a period of 180 days any time after work has commenced. It shall be the responsibility of the permitter,to assure all required Inspections are requested and approved Permittee Signature Issued By , /' - SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE i i I I I CITY•OF TIGARD MECHANICAL PERMIT Receipt# • Permit# Description Table 3A Mechanical Code CITY PRICE AMT City of Tigard _ — 1312;S.W. Hall Blvd. RETROFIT RESIDENTIAL 1) Permit Foo -0- -0- 10.00 P.O. Box 23397 FURNACE 110M BTUS - -- Tigard, OR 97223 2) Supplemental Permit 3.00 639-4175 Furnace to 100,000 BTU 1) incl.ducts&vents 6.00 Furnace 1),000 BTU 1 2) incl.ducts$vents 1 7.50 7.50 Name of Development 3) Floor Furnace 6.00 PIR DI ETZ (684 9786) - incl.vent - - Job Address Suspended heater,wall heater Address 13020 SW PACIFIC Y 4) or floor mounted heater _— 6.00 HW Tax Lot Map No. Vent not incl.in Lot ©lock Subdlvlsion 5) appliance permit 3.00 - Name(or name of business) Repair of heating,refr ig., PATRICIA SMITH 639 2067 6) cooling,absorption unit _ 6.00 Mailing Addr- 4 Phone 7) Boiler or comp to 3 HP 6.00 Owner 12195 SW 121ST absorp.unit to 100,000 BTU city/state - Zip - Boiler or comp to 3 HP-15 HP TIGARD, OREGON 97223 8) absorp.unit to 500,000 BTU - 11.00 _ Name -' Boiler or comp 15-30 HP 9) absorp.unit 112-1 million 15.00 Ai" HEATING & COOLING, INC - Mailing Address Phone 10) Boiler or comp to 30-50 HP 22.50 2915 NE UNIONAVENUE 284 2173 absorp.unit 1 -1.75 million - Contractor City/Slate zip 11) Boiler of comp to 50 HP 31.50 1 PORTLAND, OREGON 972_12 absorp.unit 1,750,000B1-U___ -_ T Stats Registration No. Cily Bs:d.Tax No. 12) Air I iut Idling unit to 4.50 10,000 CFM - - ��� 080 Air handling unit I hereby acknowledge That I have read this application that the Infoamalion giien is 13) 10,000 CFM + 7.50 correct,that I am the owner or authorized agent of the owner,that plane submitted aro in ------ — compliance with Stale laws,that I am registered with the State Builds s'Board,that the 14 Non portable 4.50 number given Is correct.(it exempt from State registration please give reason below;. evaporate Cooler Vent fan connected _ --._._._ -- _______._�---------_-`--- ----- 15) to a single duct 3.00 — - —. - - ------------ ----- - Ver,ilation system not 16) included in appliance permit 4.50 �( 11 17) Hood served by 4.50 mechanical exhaust Signature(owner or agent) .101IN S111,7ZA Date 18) Domestic type 7.50 Describe work ❑ addition G alteration KX repair ❑ _ incinerator to be done residential non-residential ❑ 19) Commercial or industrial 30.00 Existing use of type incinerator building or properly I�j � Other I.e.,woodstove,water 20) heater,soiar,clothes dryers,,Itc. 4.50 Proposed use of -- - building or property_ .__..___..__.__ - - 21) Gas pi,-ing one to four outlets 2.00 2.0 Type A fuel- oil ❑ natural gas 1X LFG [:j electric ❑ I -- 22) More than 4-per nutlet doll-cte SUB-TOTAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON -- _ 19.S. STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ 5 j; 4%SURCHARGE •g DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 26%OF SUB-TOTAL ABANDONED FOR A PERIC0 OF 180 DAYS AT ANY TIME AFTER ------- -,- WORK IS COMMENCED. TOTAL 20,4 Special Conditions -- ------ - ------- Date issued—�-__-- by ----- PERMIT TO CONNECT Tigard Sanitary District PERMIT No 909d4 DATE PERMIT IS GIVEN TO �- OF TO CONNECT A _ TO THE SYSTEM OF T:GARD SANITARY DISTRICT AT THIS P?RMIT MUST BE POSTED ON Tit:DESCRIBED PREMISES UNTIL CON- NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM- PLETED. PERMIT .FEE PAID $.... ..........................TIGARD SANITARY DISTRICT CONNECTION IN,'PECTED AND APPROVED J 0, &-0 Address Permit No. Name of Occupant______ _ _ Permit charge_ ------ Connection fee - ----- Paid b - - L to connected Type of Building-- - -- -- Inspection fee Service flate__ Paid by . - Date Contractor Assessment ------ -------__ - - Paid Size of connection r