12135 SW 92ND AVENUE 12135 SW 92NE AVFNUE _
I
I
Q)
a
a
v
y
rA
b
G
N
O�
rA
Ln
M
N
I
INSPECTION NOTICE
City of Tigard B ilding Department ,r
P.O. Box on 97
97
Ti
I gard, Oregon 97223
Phone 639-4175
Type of Inspectio '
i
Date Requested,. - Time_�_A.M. P.M.
Address _- ---. tit
Owner /,) !i�in t / � Lol/#
Builder
The following Building Code deficiencies are required to be Corrected:
i
Presented to ❑ A oved
Inspector approved
Date
CALL FOR REWSPECTION
0 YE3 U NO
I
INSPECTION NOTICE
`jl a City of Tigard Building Department
P O. Box 23397 , "�•QPM
Tigard. Oregon 97223
„ Phone 639-4175
Type of Inspection
Date Requested ��� . Y Time_ A•
Adupsss __ 1?1 Permit # �
Lot #
Owner
Builder _--- — 7
The following Building Code deficiencies are required to be corrected: T.
Presented to (] Approved
1� [ DiNpproved
Inspector
Date
CALL FOR REINSPECTION
0 YES LINO
I
CTY OF TIVA
RD
MECHANICAL ME8921
�,�� PERMIT NO. : E892192
CITY OF ikAFM
COMMUNITY DEVELOPMENT DEPARTMENT \ OPFOON
TE. ISSUED: 10/24/89
13125 5 w Mall Blvd.,P.O.Box 23397,Tigard,OrF!gon 97223.(503)639-0175 I P1,PMT.N0.
JOE{ ADDPESS: 12135 SW 92ND AVE
TAX MAP/LOT SUP: LT: Bl"
LAND USE:
LOT SIZE:
ITEM: NO: NO.-
WORK
O:WORK CLASS: ALTERATION FURNACE_ (100K AIR HANDLR (10
USE TYPE: SINGLE FAMILY FURNACE 100K+ AIR HANDLR 10Y.
CONST.TYPE: FLOOR -URNACE EVAP.COOLFR
OCCUP.GRP. : HEATER VENT FAN
VENT VENT.SYSTEM
PLR/COMP (3HP HOOD
NO.STORIES: PLR/COMP 3-15HP INCINERA1OR(DOM
DWEL.L.UNITS: PLR/COMP 15-30HP INCINFRATOR(COM
FUEL TYPE WOOD PLR/COMP 30-50HP REPAIR UNITS
MAX. INPUT PLR/COMP 50+HP OTHER 1
FIRE DMPRS? GAS PIPING OUTLETS
HIGH PRFSS?
REMARKS:
Wood-burning stove
FEES:
C
w Condon Richard PERMIT f14.50
N 12135 SW 92nd Ave PLAN REVIEW
Tigard OR 97223 FIXTURES
PHONE. (503) 620-4581 STATE 'TAX $,73
OTHER
r
O
N
T
R
A
C
T
R TOTAL: $15.23
RE'CEIP'T NO.
1 hitt permit is Issued subject to the regulations contained In title 14
of the TMC. State of Oregon Specialty Codes,zoning regulations —
and all other applicable codes and ordinances. and It Is hereby REQUIRED INSPECTIONS
agreed that the work will be done in accordance with the plans and MECHANCL.SYSTEM
specifications and in compliance with all applicable codes and FINAL
ordinances The Issuance of this permit does not waive restrictive
covenants Contractor and subs)ntractors 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 It work Is suspended or
abandoned for a period of 180 dads any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
C (
Permittee Signature
Issued By /111-) CAI I F-UR-4MSREL:TIUN-639-.4,1 25--.
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
�""r2 _0
CITY OF TIGARD MECHANICAL PERMIT Receipt#
13125 SW HALL BLVD. Permit #
P. O. BOX 23397 Description
T I GARD, OR 97223 Table 311.Mechanical Code CITY PRICE AMT
(50.3)639-4175 1) Permit Fee -0- -0- 10.00
Name of Uevr_Inpment ---`-
2) Supplemental Permit — 3.00
Job Address - I 1) Furnace to 100,000 BTU )3.00
Address 1,2/3 S" �/ 51 A incl,ducts&vents
Tax Lot � C Map No. 2 Furnace 100,000 BTU i
Lot Block Subdivtsion ) incl.ducts&vents 7.50
Name(or name of business) 3) Floor Furnace
incl.vent 6.00
Mailing Address Ph" 4) Suspended h9ater,wall heater
Owner or floor mounted heater 6.00 -
ri>yistato zip Vent not incl.in
5) appliance permit 3.00
Name(pr-came of business) Ca 6) Repair of heating,refrig.,
6.00
c�� Q , cooling,absorption unit_
Mailing Address Phone Boiler or comp to 3 HP
Occupant ,L 7) absorp.unit to 100,000 BTU t;.00
c ISState Zip Boiler or comp to 3 HP-15 HP
8) absorp,unit to 500,000 BTU 11.00
Name 9) Boiler or comp 15-30 HP
absorp.unit'/a-1 million 15.00
Mailing Address Phone _ Boiler or comp to 30-50 lip 10) absorp.unit 1 -1.75 million 22.50
Contractor Cityistate zip - Boiler or comp to 50 HP
11) absorp.unit 1,750,000 BTU 31.50
State Registration No. City Bus.Tax No. Air handling unit to
12) 10,000CFM 4.50
I hereby acknowledge that 1 have read this application that the information given is 13) Air handling unit 7,50
correct,that I am the owner or authorized agent of the owner,that plans submitted are In 10,000 CFM f y
compliance with Slate laws,that I am registered with the State Builders'Board,that the Non portable
number given Is corned.(It exempt from State registration please give reason below) 14) evaporate cooler 4.50
Vent fan connected i
---- .-- ---- _--_- -- 15) to a single duct 3.00
- — -- - Ventilation system not
16) included in appliance permit 4.50
Hood served by
17
y� ) mechanical exhaust 4.50
Signature(owner or agent) Date Domestic type
Describe work ❑ additior1❑ alterations' repair ❑ 18) Incinerator 7.50
to be done residential &3'- non-residential ❑ Commercial or industrial
Existing use of 1 s) type incinerator _ _ 30.00
building or property _ Other Le.,woodstove,water
Proposed use of 20) heater,solar,clothes dryers,etc. 4.50
building or property_ 21) Gas piping one to four outlets 2.00
Type of fuel- oil ❑ natural gas O LPO ❑ electric ❑
22) More than 4-per outlet
NO_ TICS ---
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- SUB-TOTAL �ysv
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5%SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ,_ PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. // TOTAL /5,13
Special Conditions �it/cX�-�Irftiv�o
- -- _ Date issued_by ` ___
1 f• f• � � f•
Address_.� G11� Permit No. _ _Name of of Occupant__ Permit charge
Connection fee_
- — —_ Paid by --
Date connected
Type of Building_ Inspection fee
Service Hate 2 Q Paid by Date
Contractor �' Assessment_ Paid
Size of connection
I