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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-0-Phonnee))-:-6-39-4175 fBusiness Phone: 639-417
Inspection: ' -'----���
Footing cusp. Ceiling Sprink. Rough-in Appr/Sd Ic
Foundation Plby. Underslab Mech. Rough-In Fireplace
Post/Bearn Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. S..n. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm
Water Line Insulation Tech.
Underflr. Insui Shear Wall Gyp. Bd. -Elect.
X.;i7 C Time: AM PM
Date Requested -- --
Address: _� Q�3�
Builder:
f �,�,�y Permit #:��CIJr _
THE FOLLOWING CORRECTI JNS %RE REQUIRED:
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Inspec or:
APPROVED _DISAPPROVED _APPROVED SUBJECT TO ABOVE
Call For Reinsp.
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C11Y OF TIGARD IT . f rF?t'I
COMMUNITY DEYEI DPMENT ►DEPARTMENT
13126 SW Hall Blvd.Tipa,d,Oregon 97223,8199 (503)630.4171
034N.)
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PIVI,^�` .IPE,. , 1,0; Hp. . » „ ^1 .0 Dr PERM
AIR )•PNOL INC UNITS OTHER LIN'M,.
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n ML-,icipal rode, State 0 0m, Epeci3lty Codes and asi ",her F i r ,r,iI Tn5, r, turn
aplicah r '.«ws, All work rilll 13 otne in accordarce with
r,ovf ',v . This permilL ::x h(Jil''4 If Wi''k it "G� sti. t's;'
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City of Tigard MECHANICAL PERMIT Planck./Rec. #_____
131:!5 sw Hail Blvd. APPLICATION Permit # r�r c `��%�'
PO Box 23397
Tigard, OR 97.223
(503) 639-4171
smption
Table 3A Mechanical Code CITY PRICE AMT
Job ,N' t �U LlCO ti V 1) Permit Fee Y -0- -0- 10.00
Address ap
( �D J 2) Supplemental Pemait 3.00
urnace 10 1!� BTU—
Q 1) incl.duds 3 vents Soo I
�_ -Tumace 100,00:BTU+
Owner i LL) (1, 2) incl.ducts S vents _ 7.50 �I
_ramanoe
IC t' C�✓ 4 3) incl. went 6.00
.»■ e..«wSuslbnd ater,w eater
r 3b vy 4) or flo-)r mounted heater 6.00
... '� ent mat i _in
Occupant 5) nppliair�xr permit 3.00
cay— AP Repair of ectomy,rn ng. -- —
6) coorine,absorption unit 6.00
M r er.,(comp,heat p(jmp,air con .
u yt`wK S y 7) to 3 HP abrorp unit to 100K BTU 6.00
«" der or comp,Feat pump air cond.
7 (J /�w ��� 8) 3-15 FIP absorp ur;it to 500K BTU 11.00
Contractor ,,,. / - i w n(comp, eat pump,arr cor .
�`f J,7� oma "10,) -1, 9) 15-30 HP absoip unit.5-1 m:BTU 15.00
+� T. Boiler or comp,heat hump,air cond
p 2,,1-5-2- 10) 30-50 HP absorl,unit 1-1.75 mil aTU 22 5(1
nambi-a-t5mawledgu that I have raw this applicam.that the B61575r aWp,Fir at pump,air y.
inkmmatian given is sorest,that 1 tits the owner or authorized agent 11) >50 HP absorp unit 1.75 m;i BTU 31.50
of the owner,that plans submitted are in compliance with State Air handitng unit to
taws,thn i am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the i+umber given Is correct (If exempt from State registration, Air handing taut
please gve reason below) 13) 10,000 CTM+ 750
—" on porta
14) evaporate cooler 4.50
- --went fan connected
15) to a single dud 3.00
enb atitn system not
16) irv_+oed in appliance permit 4.50
1 �J
t t� 17) mw;,tnicai exhaust 4.50
De
rcn a ition u terabon mm rxiusUsal
to be dcca residential Q non-residential Q 18) type Utdrterakw 30.00
sora use er La.,woodstovo,mater -'
a btn'kfing or property ' f Lt 19) heater,solar,clothes dryers,air. 4.50
Proposed use of 20) teas piping ane to kur oufleas 2.00
N building or property^_
211 Moro than 4-pw outlet
Type of iuoi, .of Q neutral gas LPG Q ofttiC Q -
ca NOTICE
�
Q13 Minimum Fee S25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
1F CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME Pl AN REVIrYV 23%OF SUBTOTAL
AFTER WORK IS COMMENCED. -- -`
TOTAL
Special C.rnddons_- _- _ —�— -�-
Y� Date issued by
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