11095 SW 79TH AVENUE 11095 SW 79TH AVENUE
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INSPECTION NOTICE
City of Tigard Building Department
P.C. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
7Ype of Inspection – – -----------------
Date Requested Time A.M.----P.M.
Address ���� _—�-� �` _-- Pennit
Owner----- -- Lot #----_-..W- ---
Builder
The following Building Code deficiencies are required to be corrected:
Presented to R<Pproved
Inspector
pe 1�c=-- -- -__ _ _ _ ❑ Disalaproved
Data --
CALL FOR REINSPECTION
E-1 YES ❑ NO
INSPECTION NOTICE -3 0
City of Tigard Building DEpartment
P.O. Box 23397 Q!y
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
t
Date Requested Time-- A.M. —P.M.
Address //0 79—
A , t— Permit #_ o` 3s`�
Owner_- _ Lot #
Builder
The following Building Code deficiencies are required to be corrected:
.41
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Presented to _ Aproved f
Inspector _—. - _.. �Disapprovedr"*
Date s� z—'r-
CALL
' - CALL FOR REINSPECTION
❑
YES ❑ NO
MF-X.'I--IAN.I".CAI- PIERM11'
CITYOFTIFARD FTAWET NO , : MEKOF121332
TC1TYP0jF T�IGAIW
COMMUNITY DEVELOPMENT DEPARTMENT OPINION
13125 S.W Hall Blvd..P.O.Box 23397,Tigard.Oregon 97223.(503)639-4175 CWT EK' ISSUET): 1.2/ 3/88
c-'D-rm 12td.l.
JOE1 ADDPE.SIL : 1.1095 5W 7911-4 AVIK'
TAX MAP/I. Uy "AR-il: L F :
1. AND USE :
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V E:N T VE:N*T SYS 71
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Nf I S*1'01:41 I-*--S 1. Ul P (:110M P, ,.I I 51..Irj INCUNEPATUP(WIM
DWE1 1, .UNITS : 1. F,'1 1-1 COMP 1.5 WHIZ, :I W, (C.10M
FULL. 111"PlE.- GAS 11.11-JI COMP '.-S 0-.5 0 H P RE-PA331 UNITS
MAX . INPLYT 7115000 150+11-IF' UTFIE-11.
1:)M1:-"1*1!:;'? NO C-sAS 1*":I'P:I:N(; OUTI-ETS
1-11CA-1 PPE.151!57 NO
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W To 1.)ivi,tA D(.11-1 I"VAM3, 1 $10 00
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R I I.(j iik r-cI 01•i 7:Xft1PI---.r3 $14 . 00
r'I 40NU: (50131 216••y'667 S'l'A 1'1;:' T AX 11111 .90
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This pe-mit is issued subject to the regulations contained In Title 14 11-11' NO
............ .................
of the TMC, State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it Is hereby
agreed that the work wIN be done In accordance with the plans and GAS I...:1 NE
specifications and in c3mpliance with all applicable codes and MU'LAAANGL . SY5 T*17..M
ordinances The issuarce of this permit does not waive restrictive V LNOL.
covenants Contractor nnd subcontractors shall have current city
business tax permits. This permit will expire and become null and
void if work is not started within 180 days.or it work is suspended or
abandc,ied lot a period of 180 days any time after work has
cornmr-ficed It shall t a the responsibility of the permittee to assure
all i ic uired tr155 tior,i vire re uested and approved
Permittee ignatVre
LTwi=i 1. 014 .14N5I-'jFCTT0N 639-41. 75
I*
Issued By
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
ve �r ■r � � �r r �r
! y ur- s it,,AHU MECHANICAL PERMIT
Permit #6E?
CITY PRICE AMT
Table JA Mechanical Code
City of Tigard 1) Permit Fee -0• -o- 10.00
13125 S.W. Hall Blvd. _ - -- --- — —
P.O. Box 23397 2) Suppiomental Permit 3.00
Tigard, OR 97223 -
639-�175 1) Furnace to 100,000 BTU 6,00
incl.ducts&vents -
Furnace tu0,000 BTU + 750
2) incl.ducts d vents
-- — Floor Furnace 6,00
Name of Oeveippment 3) incl.vent
Suspended heater,wall heater 600
Job �•s'�_,-, f �� -� � 4) or Moor mounted heater
Address -__�- (�`�_ Vent not incl.in
3.00
Tat l or Map No 5) appliance permit
La Bock Sum'"51On Repair of heating,refr ig.,
6.00
N.n,e(a rurne of business) 6) cppling,absorption unit34
Boiler or comp to HP — 6.00
Mai"Ad"U PhOi1e 12yb 7) absorp.unit to 100,000 BTU
Owner �� 4A) e14AI(0 Lv� vb � — ---
Boiler or comp to 3 HP-15 HP 11.00
citylstate Ziv 8) absorp unit to 500,000 BTU
Boiler or comp 15.30 HP 1500
NormJ 9) obsorp.unit'.-1 million
Boiler tx comp to 30-50 HP 22.50
Moiling Addreae 2 �0r1° r f 10) absorp.unit 1-1.75 million
Boiler or comp to 50 H P 31.50
nli actor z' 11
GtyrSwe ) absorp.unit 1,750,000 BTU
A,,4,,1 � � - Air handling unit to 4.50
state ovetration No. City Bus.Ta■No 12) 10,000 CFM
Nr handling unit 7.50
i hereby ackriawkmVe that 1 have read Otis appikaMon Mut the information given Is 13) 10,000 CFM + ---
oonect,IhW I am eb owner Of ouMMnzed agent of the owner.Mut plans submitted are In Non portable compliance wnh Slate....s,that I mom registered with the State BuOders'Board,that the 14) PD 4.50
number given is owed pt exempt horn stale registration piee•re give reason below), evaporate cooler
15) Ven!Ian connected 300
to a single duct---------------
---�---L �d -�` 16) Ventilation system not 4.50
included in appliance permit _
17) Hood served by 4.50
t mechanical exhaust
signature(owndr or agent) Date 18) Domestic type 7.50
incinerator _
Describe work El addition l.) alteration C_1 repair [Jincinerator
or industrial
--L.—
to be done residential non-residential f� 19) 30.00
— type incinerator _ -
Existing use of P Other i.e.,woodstove,water 4.50
building or properly r-___ -- - 20) heater,solar,clothes dryers,etc.
Proposed use of
budding or propeny _ -- - 21) Gas piping one to lour outlets / 2.00
Type of luel- oil L I natural gas,Pr LPG O electric (1 22) More than 4-per outlet
NQ1'ICE SUB-TOTA!
IIIIS PERMIT BECOMES NULL AND VOID IF WORK OR CON. 4065p'p .SURCHARGE
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180
-- -- ---• -- - -
I)AYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 2S%OF SUB-TOTAL --
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER "_""- TOTAL
WORK IS COMMENCED
Special Conditions
I l;tlrr estiurrd toy
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Date--__- Time
W14KE YOU WERE OUT
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RETURNED YOUR CALLAOAIN
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