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12445 SW 129TH AVENUE-1 - . � �• � � �, �)�°� � '�' ` ,��\ � . / lot , \\ 12445 SW 129TH AVENJE :y ƒ�\ �f\ �J! �\\\ �\\ �\ : . \/ Ln \\\ � f\\ . .". , >` 4 ��. 111111111 v w� 41� !Ud1 ~L " art do �4~,_ R` 4 t '.�' W �-�� ��:-•? " tau'�+�'� M^ �,• Q0 . '•.,'c._1�y��9� 14 ;� �'�am-' �'•�.,�Rfl}�'�'� %flti'., ,°f�i��,�'�r, ,/� �• +iU►,''e' �..►�`�,°�'►!r.11AI��e�i�e?Y°G t,,��i' ��� � ��� fia�rrcr^ne=t� -fi^--.^-..,. ��_�_cn-r ,rr-r-aar�-cT�--- -xat 4 • I� t ° f t° t, / I n f�► , i Pit '. Qi P F y0.co °A co Cd I, A •7 Ate/ M1�y ";; rIj G, �, O L 0C O cd D•. `lGo 1 f] '!,! U) 'b Q ►! Atli v a � to � 00 t a ratic W 04 4-1 �a `pcj h INSPECTION NOTICE City of Tigard Building Department P.O. Box Tigard, Oregonon 97 97223 1rh Jam-` Phone: 639-4175 Type of Inspection e!4z4f"2'o � Date Requested _ Time_ A.M._ P.M. Address / Z yc{ - / 2 y Permit #-3G3-0-')S.� 2— Owner ��� a't ti - o Lot # Builder T'ie following Building Code deficiencies are requited to be corrected As.." r L Presented to ( Approved Inspric^r,r F1 Disapproved CALL FOR REINSPECTION O YE• ONO 0 M m a 0 W uy N ru I Q' in a) in 13 (v 0 N Lo m 7 w En ui to X lu C34 w cla co M C3 > LD In m 4 r1- EX z z 0 61 rnna A rn n 4v a Z to 25— G ul aco 0 A, 76 u 'x —V a k 6p Lj S. ru O ry C will m AS. 0 u 0 q�q 0 000 fr tr 0 wl Z 4 mo v I -i ry N 4 L) Ci C) S, 1-0 "0 iii tCl Z 0~ if lCD - 041 � 1 Ln t 1-3 0 H Z w Ht E cz Lrl uA WNHIHN"N e j %ps r- 2-11 i + 41 10 K U ji LM pug'.V1to r4 %D u 1 E -i• '9El ; ,4 0) 1 poc a w 11 m + 44 W m C\j H 0 'u bo c z 14 c tv 0 W M•4 U 0 w w 0-4 '4 c u u R w 9 �j " NC, 0 u C: Ln >4 Oli 51co U, co m C�l u cd N W 'D 'd tu z C) N 44 &J -4 W W 0 m w Ol 04 0 (Yol tn I O co W 01 W N Q n M f•1 V; 1�,� ' � V ru N I > i i I N O ul :. u mQ 1 II n nl r°•i m j N U' Qis ':� n .. w NN o (� cls. 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I In CA Irl n a ori iWL °b€ � 4I_pa n o 0 0 c. -- 9 �� obb" � .j i �f .• m v 14oa•�h,� Eaud ¢L� cto l �4g y Iui�i Noq I USI M Afo aq-br N 1! q!T NJa r.Mo z z q .4Ow o oc) 3c �i 1�Ei{E s�9p d�GyLL,�OO�ii(Iiiu�VdoAy) Uzc8j m_`IIi v ( n u w ) x 3-Iv nen m •-m ao In, Q 2 M .:In 1 -jO m N nz I!JIt Cl c •obi a u n�r�1; "b vv j �•e��E ion.. �o N \ to In is n 1: �o.Z.lS •� ♦.1 L 'ti Q N U, 4J r\; t o t ;n•� yYg3� 1 c ro / 1 s . u I ►+ \ C rn V) tV t H y u y In O u oo e �+ (u a _ � �� W C3.-•1 ,J V to U a C •" ti I Qt!1 �U :1/1 ii_ N •I„) �.� it v1 ./•r 1 � row 1 m U w 7 rL 7 C,3 II In In I�a Ir) �� 1 00 W N ~oma a a C u lu r1 s11 F 0 Q � I,. x N `D A m r, n v v 1+d o. N z jI .. i N ■ w G. ^' f T O VI N N N O w U U4 u •r1 O b U W W .1 H 44 r' N. r - waw I ■�■.�r_� _ - - RESIDE■TIAL SANITARY SEVER AS—SNILT ' BUILDING PER14IT M0. OATES BUILDING CONTRACTORS Lae-_a(f,lp C �� SEWER CONTRACTORS SUBDIVISIONS 'Z LOTS ADORE181 DEPTH AT CONNECTION TO CITY STUBOUTS DISTANCE OFF CURB TO CITY STUBODUTS TYPE OF PIPES ..� 4 (� SIZE OF PIPES L TYPE OF CONNECTIONS _ L� S✓ ��� INSPECTION DATES - SCHEMATIC DRAWING TO BE FURNISHED BY CONTRACTOR TO CITY BEFORE FINAL INSPECTION SHOWING EXACTLY HOW THE SEWER WAS CONSTRUCTED FROM HOUSE TO CITY STUdOUTe c ir -lb I IaSASSUILT.FRN 9MRSMR91-9�IREMIERWIR!AMMR CITY OF T16A RD CITYOFTWARD COMMUNITY DEVELOPMENT DEPARTMENT 09100N PEPmxT NO. : MESS0204 13125 S.W.Hall Blvd..P.O.Box 23397,Tigard,Oregon 97223.(503)639-4175 fl^*Tr,' ;j/11 It / P1111M . PMT .NO 880202 JOB ADDRESS : 12'115 !W AVE I AX MAP/1.(Ty' 24' e1r)(1 I.'j 100 SLID : WEI-L.W000 IIT L T 1.36 1: K I. AND USE: LOT SIZE: TTEM: NO: WOPK NV:*W V1JWNAGE'* <100K 1. 0111 H6NDLP 00 tisE TYPE: SING.L,E FAM1I..Y F:'tJPNACI'--" 1.00K+ AIA HANULA 10K CONS 1 T'Yl*')V--' : VN FL O(JA VAJANAC'11' E V A P . t"001.F-K A OrCUP ,CAP . : R3 HEATER VENT FAN VENT vr:.N'f' CM BLR/COMP <3HP HOOD I. NO GJUPIL-1, 2 UL.Pic"(W-1r) DWELL ,UNITS : I SLA/COMP 1.5-3011-1P INCINEPATOW(COM 1:1.11:0. f'(PE GAS P/COM 1:*.1 111FI-101P UNI T'S MAX . 1NI-*)UT 8L..A/COMP 50.1-1-11P OTHER I'WE Ut'll"Ps'? 065 P1'PTNG OUTI-cri-5 1. 17T 1-91...:,I W N E 044300 5W PW5A 141) Pl..AN Pr1r.:V1W-.W $8. 63 Ili I ll1:4 11 X 111.1 r4r, 'lhtif�t:) or� 9*11p,'.� *P1 50 STATE TAX 0 N T A 8 HEATING' P A D161. UNUT 6C.A.-K C t1915SW U?ND TO 1 ('11.1 97P.P./l PHONE (50,111 6RA1---*,3355 I fl 1..(_j U11 I I IIA I I LIN NO .. . "5 39 Al_, 1/1 £)"1 his permit is issued subject to the regulations contained in Title 14 of the TMC, State of Oregon Specialty Codes. zoning regulations I'EtNO kM 9 6 1 and all other applicable codes and ordinances, and It is hereby agreed that the work will be done In accordance with the plans and I:'4F::QtJIPE."0 INSPECTIONS specifications and in compliance with all applicable codes and Goj LA.Nti ordinances The issuance of this permit does not waive restrictive POG T* a BEAM covenants. Contractor and subcontractors shall have current c,ly business tax permits. This permit will expire and become null and P(A.H.31 F IN void It work Is not started within 180 days.or it work Is suspended or Fl.NAL. abandoned for a period of 180 days any time after work has commenced It shall be the responsibility of the permIttne to assure all required Inspections are requested and approved Permittee: (sions sign Issued BY: SEPARATE PERMITS REQUIRED F6h4dAk'0if4Wi`AXN 699' 6169' D ABOVE SEWER PEPM I F CITYOFTIGARD VIERMIT NO. . SEF9100205 C17YOFMARD DATE ISISHI'-A) W6 nyt- I COMMUNITY DEVELOPMENT DEPARTMENT 13125 S.W.Hall Blvd.,P.O.Box 23397.Tigard,Oregon 97223,(503)639-4175 JOB ADDRESS : 1.2145 SW 129TH AVE. lI rFl NUMBEP : 3 1 j) Tj I AX Mr.,/L 01, el.66 'I . 7OO SUS: MI.LWOOD 71 .11 LAND USE: I.0T SIZE: ! SECTION: A T*WP RNG: 1w WUPK CLASIS : NEW USE 'TYPE: SINtA.-E FAM11 Y 111oh- mppl -ILarit airdreeni to with vall ruill-Uth JAIW V0511111ML:11131-114 1.)T thee Lhii+-!IocI `i e w im I-•at 9 tyr A g e n c.%; . The pormit expirew 120 ditys from them clittte iiiii8i.te(j . The tot*tj. i;ilnr)tllii. v)i-i-tic I t,11.11 bra Triil-re:11.ecl :1 -11 thro 1:)fall`M:It I'lle cloirwts.; llt!lt 1,11.Im.r--- 4:1.1-1tee tile RC?MlrftCy Of the loirottiari o the !sido Mower Imtormi.ts If LI' e nower is 11(11. loc:i" I.Ecl lat I'llo- giviaill , I.-ho -111st.oUlmal' %hil1'l.1 pi'mitipt.ocA A Te(--.-:t 1.1-1 410.1 directions from tho c1:i.iut4a.1.Ivo give,, . If Itat %,(:, 1,oc&ted , tile iinist.m.11.1or Perifill, IN-11cl tilt.? ()qeIlc;y W:11.1 filsil.191:1 io 1011,rul`011 , TINISTAL.L . TYPE : BUTLA)ING SLIMEIQ IMPEPV111:11.11S AREA: UN-TT5) . IFINIONT, 1W,-1ROVr--,M17:N*T DWELLING UNIT'S : i. idrl OF Fil UGS . I. 0 F.EES W 1.(.J[';'K 6 01.1101iff.'. 141-17-1MI T *.4.1) 00 N L)All'300 SW ROSA FID E CONNE'lCTION C HARGE 61 too 00 R th b U 1,4.1 1. INC 116F, 11*;TAL L C OTHEP $360 00 0 N 1.OR K T PINL- rPFFI-.-. INDUSTRIC'.S r91-Z')0!,"' "',!4 6 "0 C hillebrii-a (34- 9111.23 T 0 PHON11i: 619 60P-r RI pl.- *30440 1 CISTPATION NO. 113TAL. iiii ,A195 On This permit is issued subject to the regulations contained in Title 14 WCEIP'T NO of the TMC, State of Oregon Specialty Codes,zoning regulations .......•---- and all other applicable codes and ordinances, and It Is hereby PFQt.J1I1- F;.I) INSPlin.0,1IONS agreed that the work will be done in accordance with the plans and N specifications and In compliance with dil applicable codes and ordinances The Issuance of this permit does not waive restrictive covenants Contractor and subcontractors shall have current city business tax permits. This permit will expire and become null and Vold if work Is not started within 180 days,or If work is suspended or abandoned for a period of 180 days any time after work ties commenced. It shall be the responsibility of the permittee to assure all required inspections are requested and approved Pe-r m-7—Itt:Ze.'I gl6niao t i i r—v Issued By ...... JI'l I I!,Itj >{r ') .. SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE CITY OF TIFA R® `` 'A� 8ING ORIGON P"Llit1 COMMUNITY DEVELOPMENT DEPARTMENT I-*)ERMT'T NO. : PLOS0203 13125 S.W Hall Blvd.,P.O.Box 23397,Tigard.Oregon 97223.(503)639.4175 F/11. /80 PR:1l" - PM'r .NO - 88021I.P. JOH AUIDPESS: 1BA45 SW tP.TTH AVE I f)X NAP/I. 01 PS qAA :1.1 700 1M.11D. DE'll-LWOOD T11 L. T 1.;36 RK LAND USE: 1.01 SIZE: ITEM: NO: W(:J1-,41( (:,I A55 : 14EW W61 E.,1:4 cl-OSE:T' 1 PAP USE TYPE : SINGLE r:*r%mTL.Y UPINAL BKI::'I.-(3W PRVNTP V;0NF;T TYPE : VN I. IPAP P11-:11ML-34 OCCUP .11,0114111P. : RJ nm SHOWER P.. GAMEASE TRAPS GvARBAGE DISPOSAL 1. s'1'ur-43,E5 : P-2 WA5 01-111911" .1 DWI-'-LL.L)Nvrs : I 1..F;tmur;jy 'TRAY 1. BI DG— DPATN (DIA �-;'LOOR UP6,1N !iINK 511EWEP (FT) 1I.A4 '(VT 844 HER MAPK S lifted 0 W N E I-OLKS I.A.1r1NE' i.+.'Rm:t r I.-M."500 Fit.. Po f) J'il') hi.11vtbar•u (:)I., 9/1e.?'5 F'IXTUf-IE"S C 111110IM7 M-1071 x;•161'11` FAX 0 N T C A DAY PLUMIAING T 71a/40 !'iW 18-IF11 PI A(l,F.-. 0 9,1007 R 11EGTt'3'1*PAJTON NO 413028 'ro T'AL : 111111I.A7 . 00 This Permit IS issued subject to the regulations contained In Title 14 of the TMC. State of Oregon Specialty Codes, zoning regulations WECU.A.P't NU PS96,11 and all other applicable codes and ordinances. and It is hereby agreed that the work will be done In accordance with the plans and specifications and in compliance with all applicable coder and INSPE:11-1 1UN5 ordinances The issuance of this permit does not waive restrictive rAL18. UNDEASLAS covenants Contractor and subcontractors qhali have current city x'(:151 & WFEAM hUsIness tax permits This permit will expire and become null and WA1TE14 LINE void If 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 commenred It shall be the responsibility of the permittee to assure PAIN I)PATINIS all required inspections are requested and approved F, 1 NA1, Permittee Signature Issued By SEPARATE PERMITS REQUIRED FO" WORK OTHER TMW 7F8CRIBED ABOVE -N_xw_xl CITY OF TI A RD C"YOFTIGARD 131-JILM.NG PE-RMA I OREGON COMMUNITY DEVELOPMENT DEPARTMENT I:*J411`111'T NO BUE38020i.2 13125 S.W.HdII Blvd.,P O.Box 13397.Tigard,Oregc-37223,(503)6394175 E: 1 SSIJEA) 2/I US PPIM PM*T*,N(:). JOB AUUPESS . 12.145 SW IL39'TH AVE IAX IIIAP/LU'y V4_4111. 1M.11EV UIEIJ.WLIOD 11.1 t. 1 '1 M, UK LAND USE: 61111131�1 SE! I WACKS VRON,r : F0 RE'AP: WORK CLASS : NEM DWELL. UWUTS ; I LE'IFT : io fisclitri: 30 NO LILE)POUMF, S L;. :X I WAL.I. CIONS'll' . CONST . TYPE:: VN NO. BATHS : 3 N: S E 1,1 CH:,U.Jr, r,;NP lnx.,Vy OCCUP. LOAD N S . F W I ut tv A r;l r..:.,A 13?av t ST 603 ROOF CUNST: F-Mr.- HH'A01,41 0 PNU 696 AM;A Fil'.13AP11 PA 11-D BASE-:MIENT7 3PO: OCXAJP - SE:PAP'? PAI E.D 114 1 r4k-_­( F1'L.001-41 LL)Ar) Al CAPAGLI : 180 F 1 PE: 51:`P I<L..P7 AI..A 1:11 M I? 1­I[E-.'.A'T TYPE' : GAS HOOP . A(XE*S$7 k-onIX.? AN C34f. Ili if I,. fit 4 . 0 W N E I .0EI(5 I -a 1:1Cl I o r3r y 7 1 F3 i .1 14C. EA I C LrI I's I F-. I 1,IX ok 1 o 0 r Ii 1C R N !11.I'I'Ll 'I Il't if. fit I (14onGf: T R L.OE:K5 DUANe: suc( !; room) 111111250 . 00 A I J li* 1 1141)11 , 11 vi 1. 14 4 0 00 C T W4300SIA11 4'05A Pf.) $250 00 01 111 1 1141111I...A (.1 R III 1' .11' 1 Of) 00 V111.IUNE 111."ItIIII-16,11 lf')N 141.1 .Ao 1110 .10 '' hls permit Is issued subject to the rag ilations contained in Title 14 of the TIVIC. State of Oregon Specialty Codes,zoning regulations 4,IE`(;EJP*T NO and all other applicable codes and ordinances, and It Is hereby agreed that the work will be done in accordance with the plans and specifications and in compliarce with all applicable codes and I 141-J) .1 N 1;r': IF 1't N 5 prdinances The issuance of this permit does not waive restrictive 1 1101 1WI' 14 covenantiI Contractor and subcontractors shall have current city 1�OUNUO41 1.(?t4 WALL 14AIN UPATN'i business tax permits. This permit will expire and became null and 4 Fit'61"1 void if work Is not started within 180 days,or if work Is suspended or 'iabandoned for a period of 180 days any time aftes work has PILO 11INUIEPSLAIR •-rommenced It shall he the responsibility of the permittee to assure nil reauired Inspections are requested and approved 11131.'40111111 1 1 lom I tq(.. 11 1 it IA AI:1;: Of. .f 11 ,_ Permittee Signature I it A I Ir(,.)N CY1 111 Issued By • SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE CITY OF TWAY RD ® PLAN CHECK APPLICATION CFTYOFT COMMUN" DEVELOPMENT DEPARTMENT MOON AL PLAN CHECK 13125SWHOBM1 P.O.Bac 29397,nye,o,.Qo„9722160)63"1m PERMIT 0 �� �jv'�o �-- DATE ISSUED JOB ADDRESS: j ( t ')7 TAX MAP/LOTs,7S' �,4 11 ,760 SUB: - , 1 �; LOT: _(t LAND USE: U VALUATION: / • 3 , SETBACK RONT: REAR: LEFT:_ RIGHT: WORK CLASS: pw HEIGHT: _ u� TOTAL AREA: lZq I USE TYPE: S F FLOOR LOAD: 1ST: CONSTR TYPE: — HEAT TYPE: 2ND: OCCUP GROUP: � DWELL/UNITS: 3RD: OCCUP LOAD: NO BEDROOMS: �� BASEMENT: NO STORIES: L NO BATHS: —�� GARAGE: r' IMP SURFACE: APPROVALS RF.Q'D SPECIAL NOTES_ ITEMS REQUIRED PLANNING: REISSUE OF: LIS/SUBCONTRACTORS: ENGINEERING: LAST REISSUE: BUS TAX: FIRE DEPT. : _ _ FLOOD Pi AIN/ CALCULATIONS: _ OTHER: SEN LND.: TRUSS DETAILS: PARKING PLAN: -" LANDSCAPE PLAN: PLA11 CHECK BY: OTHER: COMMENTS: ,.+ .3 i7�' ,, ✓_�: _ e , r. v '—ACCT DESCRIPTION UNT OWNER _ _- 10-432 Building Permit Fees 3Y3 NAME S-+ 10-431-600 Plumbing Permit Fees ADDRESS: 10-431-601 Mechanical Permit Fees , 3 s0 10-230-501 State Building Tax (5_X)93." 10-433 Plane Check Fee PHONE: 30-443 Sever %�onn^.ction (20%) V.&.1 3i 30-202 Sewer Conn,�ction (80X) s CONTRACTOR 30-444 Sewer Inspection t ,y5 NAME—: a .51-448 Street System Dev. Charge (SDC) $ G 0� ADDRESS:_A*,3f-, -,-i4 . }2, '.52-449-610 Parks I System Dev. Charge (PDC) $ -A .5 0 52-449-620 Parks II System Dev. Charge (PDC) 3 31-450 Storm Drainage Syst Dev Chrg(SSDC) S 0 PHONE: 7 10-230-505 TRFD (95x) S 10•-435 TRFD (5%) S __ ARCH/ENGINEER 10-230--506 Waah.ngton County Fire /1. (95x) NAME: Lp e C! y 10-435 Washington County Fire /1 (52) ADDRESS!_ 7`— 10-220 Amart/Wedgewood _ TOTAL P1 fb;I Q3 PREPAID IVIG bhp ,'tv y RFC 0 t BAT..ANCE DUE U I-F APPLICANTSI N TURE I 3�` `�-Ytc Received By: Date Received: P.O.Box 23397 C ITY OF TIGARD PLUM 131 NG 1-1175 SM RaU Blvd. Applicants muss hold Oregon Registration to conduct z plumbing Tigard (.R 97223 PERMIT 639-41.75business or must be lwoperty owner/oXrator nowt hiring outside help. Nam i of D•Yvelopmenl - �0 ^ 3 PlumbrnK Permit No. .�__ Address Description +� ORS 814-21-610 QUAN. PRICE AMT Job Tax lot _ Map.No. -- Address FIXTURES Lot Hkxk Subdivlskxr --- - - Sink / 7.50 7.50 Name a name o Fiusrness Lavatory ---- 7.50 .d'?.SU Mailing W _ -_ Tub or Tub/Shower j,c.Comb z. 7.50 v r®ss -- Shower Only 7.50 OwnerCky�/`late ---- -- --- Tp Water Closet _ - ,� -7.50 1Z•3", Dishvmsher I 7.50 y. v Phone Garbage Disposal- - / 7.50 7.50 Name '-- - Washing Machine - J - -- 7.50 7 00 _Floor Drain ai Prig WaUress Phone - Water Heater - f J 750 7.f0 Occupant City/Sleds Zip Laundry Room Tray - 7.50 7 3 Urinal 7,50 Name Other Fixtures(Spodfy) 7.50 _ Mailing Address -- 7.50 ` Contractor 04'/State - Zip -- - -- 7.50 - -�-_ _ MISCLLLANEOUS j City Bus. Tax No Sower t at 100' 30.00 State BI&js Board No State Plumbers Bus Lx. o Sewer-ea.Addit,100' 15.00 _ (Residential) water Senrios tat 100' -1 20.00 I hereby ack werbrlpe that I have read this appkAdIon,that the Intoxmatkxi water servios so.Addil.2001 15.00 given is oorrft' th-t I am rVetered with the Stats Builders Board,and also Storm&Rain Drain 1 at.100' 30.00 have a State Plumbkny Noexnee that the rxxnbwv ylven are correct,tha,all - plumbing work wig be done in aocordenoe with appscable provisions of Or a Storm&P:kn Drain Addl.100' 15.00 gon Revised Statutes Chapters 447 and 693 and applIcsble codes and that Mobile Horne Spsoe 25.00 no help will be empbyed unless Ik�onaod undo,ORS 663 (11 exempt from ----- --- - - Stale re0stration,pleare Sive reason below) Back Flow Prwention HOMEOWNERS -1 hereby oertify that!am the owner of tint property de- DevIce or Anti-Pu*,Uon Device 7.50 -- aalbed above,M which"Itlon 1 propoee N maks a pk anbkV installation tcx Any Trap or Waste Noi my own use and thh vgwty is ria F,ekg axrinoot!for sale,lases or rent Connected to a Fixgxe _ 7.50 Catch chain 7.50 k"..1 Exh".Ptumbiry _ 40.00 Per Hr. _- - - Spedatiy Requested Inspections 40.00 Per Hr _--- ---- Alter of okimll*V within an Exfe"Bldg 15.00 rrtln I,01HORiZED SIGNATURE -- -�- Dat" Now Bldg or Hulld.Addison �-_ 25.00 Rin. L'1esr..:,s work no,,[ ) sdditkm[] alteration❑ repair (] (34 au. v r 15.W be dorm _ residantial( ] _ non-residential f 1 _ Erdsikp use of _ bul%*V or property ---- --- -- - NN-T* l A�U40 o yrf ' NNICf/A1k d d G - - ___ ---_---- --- - NOTTt7TI�l ICE Thla pa nes beaoiv a mm and wild a work or oonahuason auswrjtod is not(ym) MWIM I wIlIld 160(k Y§jor N onnaMuallim or work is ousperdad or abandoned for a period et 190 days M any ame alter+work is oormnerw3ad *ftCIAL'JONWiC%dl --- -.�� - -- - - -- Dale lsstwi by IMMM JUN CITY OF TIGARD MECHANICAL PERMIT celp Pett: Description Table 3A Meeher teal rude OTY PRICE AMT City et Tigard ---T 13125 S.W Hall Blvd. 1) Permit Fee -0- -0• 10.00 P.O. Box''3397 -- Tigard, OR 97223 2) Supplemental Permit 3.00 639-4175 Fumace to 100,000 BTU 1) incl.dty4s&vents f 6.00 L' Fumace 100,000 BTU + _ 2' it v1.ducts&vents 7 Nw*d -vstoprear,t FP"Fumace -- 3) Incl.vent s Job — Suspended heater,wall heater Addrf,<;s 4) or floor mounted heater 6.00 "I'm tot - Map No. Vent not Ind.in .at- t subdivision 5) applie Ice permit 3.00 name(or name of business) Repair of heating,refr Ig.,6) Cooling,absorption unit 6.00 Owner LWWV Address D'o'te 7) Boiler or comp to 3 NP �- ab ftp.unit to 100,000 BTU 6 City/State zipBoiler or coma to 3 HP-15 HP 9) absorp.unit to 500,000 BTU 11'00 --- Nwft 8) Bdlerori=V15-30 HP absorp.unit Ih-1 million 15.00 M&*D Adam Phone 10 Boiler or comp l o 30-50 H P 3b3orp.unit 1 .1.75 million 22.50Contractor City/State — �v ZIP 11) Boller or comp to 50 HP absorp.un1.1,7f,0,000 BTU 31.50 stale Reg WnWn No. Cay BM Tax 1*, 1.2) handling unit to 4.50 12) 10,000 CFM I Iwweby ndaxwMdge wU I haw fund"a kation that Ow)kHormLuon ptven Is 13) Air handling unit--- 7.50 — - ca Iwd,#W I am the ow.wfr(r autrvrtred apern of Mea owner.that plane Wynttted we In 10,000 CFM + ccxnpilsnce with State laws.Ilei I am registered with Mw Slate Buaders'Bcwd,that the Non portable —-- — number given Is correct (a exempt hom State registration please"reason bebw). 14) evapot ate cooler 4.50 - — Vent fan connected ------------- ------- -- 15) le to a singduct 3.00 -' `1--- --�— — Ventiletinn system not ------` —- 16) Included In appllance permit 4.50 Hood served by - - 17) mechanical exhaust 4.50 ti Bpehsu(owner a agerh) -__.___-- Oats Domestic type tw Describe t%* UJ addition Elefteration ❑ repair ❑ 1l3) Incinerator 7.50 Ic be done __ residential ❑ non-residential [j Conxnergal or Industrial Existing use of t 9) type Incinerator 30.00 Widing or property Olh%r I.,%,woodstove,water --- Pn)posed use of 20) heater,-Mar,clothea dryers,etc. 4.50 building or property 21) Gas piping one to 1.^ur outlets — -` 2.00 7 �rype of fuel- oil 11 natural gas O LPG ❑ electric h — — 22) More than 4-iter outlet THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- SUBTOTAL 3 STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN too _ S7-Q 4%SURCHARGE 3 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDFD OR PLAN REVIEW 25%OF SUB-TOTAL ARANOONED FOR A PERIOD OF 100 DAYS AT ANY T.ME AFTER t. ') 1K iS COMMENCED. TOTAL �. Special Conditions — —. Date Issued _ by----