11300 SW 92ND AVENUE 11.300 SW 92ND AVENUE -
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INSPECTION NOTICE
7 City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection,,,ZA
Date Requested I —� J ' !EeL) Time A.M. P.M.
Address Permit #�l`7'=�?!s q.
Owner Lot #
i7
Builder
The fol:owing Building Code deficiencies are required to be corrected:
Presented to _ - _ __—. -�}Approved
Inspector Disapproved
— - -- - — -- Disapproved
Date
CALL FOR REINSPECTION
❑ YE! 0 NO
CITY OF TIGA ERMITM O. : PERMIT
RDPERMIT NO. : ME892695
Cm�Ru
COMMUNITY DEVELOPMENT DEPARTMENT 0*100N D E ISSUED: 12/26/89 �
13125 S.W Hall Blvd.,P.O.Box 23347,Tigard,Upon 97223,(503)639-4175 111.PMT.NO. 892695
JOB ADDRESS: 11300 SW 92ND AVF
TAX. MAP/L-OT SUB: IT: BK:
LAND USE:
L01 SIZE:
ITEM; N0: N0:
WORK CLASS: ALTERATION FURNACE (100K AIR HANDLR <10
USE TYPE: SINGLE FAMILY FURNACE 100K+ AIR HANDLR 10K �
CONST.TYPE: VN FLOOR FURNACE EVAP.COOLER
OCCUP.GRP. : R3 HEATER VENT FAN
vENT VE�!T.SYSTEM
DLR/COMP (3HP HOOD
NO.STORIES: 1 BLR/CAMP 3-15HP INCINERATOR(DOM
DWELL.UNIIS: BLR/COMP 1.5-30HP INCINERATOR(COM
FUEL TYPE WOOD BLR/COMP 30-50HP REPAIR UNITS
MAX. INPUT BLR/COMP 50+HP OTHER 1
FIRE DMPRS? GAS PIPING OUTLETS
HIGH PRESS?
LOW PRESS?
REMARKS:
Install Chisli Liner
- FEES-
0 Bill Crandall PERMIT $10.00
W 11300 SW 9cn6 Ave PLAF' REVIEW
E Tigard OR 9722.? FIXTURES $ 1.50
R STATE TAX $. 73
OTHER
N CHIM PRO CO.
T 2306 SE 190TH AVE
A Portland OR 97233
T PHONE (503) 669-9301
o REGISTRATION NO. 60969 TOTALt f15.L'3
R
RECEIPT N0. 't=(t(o' /q
This permit is issued subject to the regulations contained in Title 14
of the TMC. State of Oregon Specialty Codes,toning regulations REOLIIRED 'NSPECTIONS
and all other applicable codes and ordinances, and it is hereby MECHANCL.SYSTEM
agreed that the work will be done in accordance with the plans and L'I NAL
specifications and In compliance with all applicable codes and
ordinances The issuance of this permit does not Naive 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 permittee to assure
all required inspections are requested and approved.
Permittee!Mg
Issued By CALL FOR INSPECTION 639-4175
StEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
® WXW—tN IR W
CITY OF TIGARD MECHANICAL PERMIT --
1312 5 SW HALL BLVD. Permit #
P. O. BOX 232-97 Description
T IGARD, OR 97223 Table.1A Mechanical Code _ QTY PRICE AMT
(503)639-4 175 1% Permit Fee -0- -0- 10.00
Name of Development 2) Supplemental Permit 3.00
1 --- —
Job AM,es. — 1) Furnace to 100,000 BTU 6.00
Address pC 9 2_^_K f/5' incl,ducts 8 vents
Tax Lot Map No. ) Furnace 100,000 BTU + 7.50
Lot 13"A- Subdmsbn 2 incl.ducts&vents
— - ----" Name(or name of twslness) Floor Furnace
' 3) incl.vent 6.00
Maiwnpaddress Phone 4 Suspended heater,wall heater 6.00
Owner C>(� S w <' ✓� ) or floor mounted heater
C*Yl�to
5) Vent not incl.in 3.00
appliance permit
Name or name of business) 6) Repair of heating,refr ig., 600
i
l � L cooling,absorption unit
Mal—ling Address�- Pttate 7) Boiler or comp to 3 HP 6.00
Occupant absorp.unit to 100,000 BTU
City/State Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU _
Name 9) Boiler or comp 15-30 HP 15.00
-�
absorp.unit'/z-1 million
Mailing Address G Phone 10) Boiler or comp to 30-50 HP 22.50
L U�' ,C r!L 1h absorp.unit 1 -1.75 million —
Contractor chyistate by 11 Boiler or comp to 50 HP 31.50
c` 72
7 2 ) absorp.unit 1,750,000 BTU
State Registration No I\ I City Bus.Tax No. 12) Air handling unit to 4.50
w00 10,000CFM
1 hereby ar..cnowledge that 1 lave read this appla:ation that the information handling uniton given is 13) 10,000 CFM + 7.50
erxrect,that I am lf-w owner or authorized agent of the owner,that plans sub bitted are in
co'"ance with State laws,that I am registered with the State Builders'Board,0ml the 1^) Non portable 4.50
number given is arrnd fit exempt from State registration please give reason below). evaporate cooler
) Vent tan connected 3.00
15 to a single duct
---- - - ----- Ventilation system not
16) included in appliance permit 4.50
- -- - )-- 17 Hood served by 4.50
- tL� I , ) mechanical exhaust _
Signature- ( wr r or agent) C7 •� DateDomestic type
1 B) 7.50
Describe work ❑ addition F] alteration C3 repair E) incinerator _
to be done residential rion-residential ❑ Commercial or indus',ial
Existing use of 19) type incinerator 30.00 -
building or properly — 20) Other Le.,woodstove,water 450
Proposed use of
heater,solar,clothes dryers,etc. Lf,SD
building or properly
21) Gas piping one to lour outlets 2.00
Type of fuel- oil ❑ natural gas ❑ LPG ❑ electric ❑
22) More than 4-per outlet
NICE SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%SURCHARGE 173
DAYS, OP. IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
Ap ANOONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL
Special Conditions 4142 16ve'
_ _- Date issued- �� _b `-
SEWER PERMIT 1`4?
Ul4Unified Sewerage Agency !/
otWashington County CITY OF � DATE
0WNER : ��rsh � - __ — -- -- PHONE :
OWNER 'S ADDRESS: J113oU 1561 �Lx nf�:
TYPE OF INSTALLATION :
IA BUILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY:
❑ NEW SINGLE FAMILY ❑ COMMERCIAL
JVI EXIST. (PRIOR TO 7-1-70 ) ❑ MULT. RES. ❑ INDUSTRIAL
FIXTURE UNITS DWELLING UNITS
ADDRESS OF S-fRUCTURE : AbDv
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION,
PLEASE REFER TO THE PERMIT NUMBER. THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL_ BE FORFEITED SHOULD
EXPIRATION OCCUR.
FEES:
PERMIT FEE s 2r
CONNECTION CHARGE 3 O U
SIDE SEWER INSTALLATION
OTHERISSUED BY
TCTAL s30 _�
P CtCAN 1� � DATE
SEWER PERMIT Na--
ADDRESS OF STRUCTURE
TAX MAP S ( - 3,�` �F� - TAX LOT SYSTEM
LOT _BLOCK _ __- _ OF
AP OVER BY DA1F _ ISSUED BY DATE
D. U. 'S REMARKS �n