14275 SW 112TH AVENUE ®L i w w i
14275 SW 112TH AVENUE
v
"r.
v
N
V)
Lr)
n
N
1
W W ■ W U FW
INSPECTION NOTICE
City of Tigard Building Department
12420 S.W. Main St.
Tigard,Oregon 97223
Phone: 639-4171
Type of Inspection --
Date Requested �.'_ Ti e r A.M. ) P.M.
Address �_ - 1— ,'! - � Permit
Owner Lot
Bt dlellz
The following Building Code deficiencies are required to be corrected:
i
Presented to n Approved
Inspector Disapproved
Date
CALL FOR REIAWPECTION
0 YES E) NO
Y
City of Tigard Mechanical Permit
New installation ❑ Replace ❑ Relocation❑ Addition ❑ Alteration ❑ DATE:
HEATING
CONTRACTOR �_--__^_— _ OWNER
ADDRESS--.-_ _—_____ —_ JOB ADDRESS
PHONE- --_ APPI.ICANT
Heat Input Rating(BTU per Hour) —.— Vent Size Flue Size —
FUEL OIL❑ GAS ❑ ELECT ❑ OTHER
ITEM NO. FEE — ITEM — NO. FEE
For Issuance of Permit _SEE BELOW Each Air Handiin Unit or Duct System_ 7.50
New-up to & incl. 100,000 BTU 6.00 Commercial_Hood System _ _ 7.50
New 100,000 3UT's & over �_— 7.50 Othar Equipment Each _ 4.50_
Woodburning Stove 4.50 1 Trip Inspecti,)n 4.50
Well-Floor- Suspended _ _ 6.00 Air Condition Compressor- up to&incl.3 H.P. 6.00
Sy
Vent System Fan ._—._ —_� _ 4.50 _Air Condition Cu_mpressor-3.1 to 15.H.P.incl. 11.001—
Repair-Heat Cooling —� 6.00—
-- —
CITY
BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 10.0 — Comments: ---,.-.----- --.---___—,- _----,--..---___-�
_FEES _
SUB-TOTAL _
% STAW, —�-- Issued By_—_.-----_-_---
25%PLAN.CHE ,
TOTAL _ _ REC. # ___ ______.. _ __
-` `--` �signature of Applicant
i
i
i
I
--
Address___ 7 S- �t f / -� Permit No. �{
Permit charge
Owner t TL j, Connection fee
)S36U w , //(0 ty, _ Paid by
'Type of building Qe-a- Date connected
;service rate� �� �'u "k Inspection fee
Contractor Paid by date
Size of connection � �� �� Assessment paid
J