11375 SW 92ND AVENUE-1 11375 SW 92ND AVENUE —
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INSPECTION NOTICE
City of Tigard Building Depdrtmert
P.O. Box 23397
Tigard, Oregon 97223
�,,,�,.CJ✓� Phone 639-4175
Type of Inspection •---
Date Requested - �n /y2__ — Time A.M. P.M.
Address
Owner r/ �JLoot�#E
Bidider � �s�lt.� —_- 4 �'S �.GS f'/.�1"/ �..7LiZ.
�
Thr following Building Code deficiencie% are required to be corrected:
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�� �1.41q.SC�.tt,�v ✓�,c�,.iE2 c:✓r;Lt, /2 S_ !�'�!/_7,'��,�%G.ii
�l6 -
Presented to .J �� 4�-Apprcved
I'
Inspector � r _ H Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
-TC�
ORIGON NEC H rl 1,11 C L
TM OF T1��RD I,:.I.-R 111 T 0. » » . . .. . NEC90-0203
COMMUNITY DEVELOPMENT DEPARVgW cn RD R111:, 1'-*1l'-.R1111T it.. . 11111.("30-0203
13125 SW fids Blvd. P.O.Box 23397,Tigoud,OroWn 97223 (603).&19-4175 �ATF ISSUED: 09/2�/9'0
SUI.'IDIVISION. . . . - DOGWOOD RIDOGE
. .1. . ZONING: R--4. 5
BLACK. ,, . . . . . . . . » L 0 T. 5
.....................
CLASS 0 F* W 0 R 14, ALT FLOOR 1=URN. EVAF, COOLERS:
IYF,I.*:* OF USE. .. . . -SF UNIT HEW'ERS. VE,N'T FANS. . . -.
OcClUl:)ONCY GRP. ..R3 VENTS W/O APPL.", VENT SYSIE1,11-3.
,3 T'O RIE E4OJLER13/CO11PRF.-',GSGRS HOODS. . . . . . . .
1.1 E-.-I TYPES__---..........._._....._...._ 0--3 Hl.". DO1v1V.'%*S.. TNC:'.[N-
G 0 3-15 HE'. C01'1111... .T:NCIN:
1'IfaX 111 V,U 1, BTU IIS ::3H 1.11,,
R E P()I R U 1,4 1 1'S:
FTRE:. D(41v1PERS?,, 30--`5A HP,. WOODSTOVES. . :
PRESSURE'. » » » 504- 1.41-1. C, -0 1)PY["R S.
1,10'. OF Al R H Pi N D L 1 N G LIMITS OTHER UNITS.
FURN ( 1001/\ FITU,.- J. <:r-- 1.0000 (- fni: Gf-)S OUTLETS. :2
I-URN >=:100K BT(.),- > 10000 c.,f n1'.
R(.-n)A r P.S
........... FEE'S
VIF'r)FFLE. type a ni 0 LM t by d a t -r e c-p t
1 13 7:`.'i SW 9r 1\1 D PRII T .1.8. 00
5PCI* 1, 0. 90
ii.k.-JORD OR, 9,72213 F'A'Y 14 $ 1.14, 90 JLH 09/27/90
Phc)iie
L",a)I t,r c,t 0 r
ARF:(-.)W IIE CHON IC:()L. ('01\11'1,. ;,N(.,,.
1.0330 SW TUALATIN RD
11.101.4)TIN OR 97062
P,h o ii e ti 6 2-. 1.;5r:,5 1.8. 90 TOTAL.
Req ft. 05193
FSE-QUIRLD INSPECTIONS
This permit is issued sub,iect to the regulations contained in the Filial I Iis)pect iorl
Tigard Municipal Code. State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work, is not started
within 180 days of issuance. Or if work is suspended for more
................
than 180 days.
............................
1. 1'11l it"t I-V 9 11 1.1 C�1,U'f'(-t
.................... ...........
I'S SUed E4,y a
..........
. .... 539-•41';5—--*
YTY OF TIGARD RECEIPT OF' PAYMENT RECE I PT NO. :90-205241)
CHECK AMOUNT x 18.90
NAME ARROW MECHANICAL CASH AMOUNT Q.0Q
ADDRESS = PAYMENT DATE n 09/27/90
BLI14D I V I IS'l ON
I'Lik-ATIN. OR 97062 11375 SW 92ND
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMLNT AMOUNT PA I D
10. 00 ST. LSU IL.J) PER
1
TOTAL. AMOUNT PAID I B. 9C)
CITY OF TIGARD MECHANICAL PERMIT Receipt # _
13125 SW HALL BLVD. Permit #
P. O. BOX 23397 �� / 1J J Description ---
TIGARD, OR 97223 s Tabk JA Mechanical Code CITY PRICE AMT
(503)639-4175IIIIII �S/,//_0 1) Permit Fee -0- -0- 10.00
Name M Oewsbpmerq /- (�
�ii.'E'ICJt��✓ �f"�(�-�rL� 2) Supplemental Permit — 3.00
Job Address - - 11 Furnace to 100,000 9TU / f v
n G.00
Address ��3-7J`' &&/. C'` _ - incl.ducts&vents /
Tax MaPl4o, Furnace 100,000 BTU +
�) 7.50
incl.ducts 8 vents
Lot fllock Sivisiah -- —
Name(or name of business)—� -- Floor Furnace —
3) incl
vent
6'OQ
MalfirV Address f Kx,c - Suspended heater,wall heater
Owner - 4) or floor mounted heater 6.00
City/State Zip Vent not ind.in
5) appliance permit 3'3.00nc
Name(or name o(business) Repair of heating,refrig.,
J'/f/,� -G) cooling,absorption unit _- s6.00d —
Mailing Address F'txxhrt Boiler or comp to 3 HP
Occupant Mailing
absorp.unit to 100,000 BTU 6.00
ctyistak zip a-- - g) Boiler or comp I_3 HP-15 HP 11.00
absorp.unit to W),000 BTU
Name Boiler or comp 15-30 HP
`el /rdS, - 9) absorp.unit 1/2-1 million -- 15.00
Mailing Addrew PIK" 10) Boiler or comp to 30-50 HP 22.50
� � /� �� absorp.unit 1-1.75 million
Contractor city�stete sip 11) Boiler or comp to 50 HP 31.50
ju /� � absorp.unit 1,750,0110 BTU --_-__- -
State Registration No. City Bus.Bus.Tax No. Air handling unit to
10,000 CFM 4.50
Air handling unit
I hereby acknowk ige that I have read this application that the information given is 13) 10.000 CFM 4
orxract,that 1 am m
the over rx nuthorized agent of the rhwnor,that plans sutxrhitte d are in — --------
compliance with State laws,that I am registered with the Stale n4 iklers'board,that the Non portable
number given is conwd (if exorrpt from State registration pwase give reason bet.aw) 14) evaporate cooler -^--- — 4.50
Vent fan connected
1 to a single duct 3.00
-' -- - ---
1 Ei) Ventilation system not
included in appliance permit 4'50
Hood served by
17) mechanical exhaust 4'50
somfte(Wmwi°r apffl) Oak Domestic type
Describe work ❑ addition ❑ alteration ❑ mpelr (7118) incinerator 7.50
to be done - residential ❑ non-residential ❑ Commercial or industrial
Existing use of` - 19) type incinerator _- -- 30'00
building or properly —�� Other i.e.,woodstuve,water
Proposed use of 20) Other
solar,Clothes dryers,etc. 4.50
building or property _
2 t) Gas piping one to lour outlets ✓ 2.00 �J�
Type of fuel- oil [7 natural gas f I LPG ❑ electric I I -
22) More than 4-per outlet
NOTICE - - - -
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
SUB-TOTAL
STRUCTtON AUTHORIZED IS NOT COMME,•4CEn WITHIN 180 5%SURCHARGE
DAYS. OR IF CONSTRUCTION OR WORK ItS SUS'ENDED OR PLAN REVIEW 25'X.OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DA,S AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL
Special Conditions
i
-- --- Date issued_- by
fly
Address Permit No.
Name of Occupant__ Permit charge
Connection fee_—_
Paid by —� --
Date connected
Type of BuildingInspection fee___ __ --- -
Service Rate _, D� Paid by Date _
Contractor_ __ Assessment______ _ Paid
Size of connection J -