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INSPECTION NOTICE
City of Tigard rsuilding Department
13125 SW UAII Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone: 639-4175 Business Phone: 639-4171
Inspection: _
Footing Plbg. Underslab `ech. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas L FINAL:
Foot/Bea4 Struct. San. Sewer Friming -Bldg.
Post/seam scc.n. Rain Drain Innulation -Plumb.
Plbg. Underfloor. Witter Line Gyp. Bd. -Mach.
Date Requeotiid: 1^�r� � _----Time: PM
Address.._�� Pec�init f: z
Builder
THE FOLLOWING COR1,9CTIONS ARE RRQUIRED�:L
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DISAPPROVED �, APPROVED SUBJECT TO ABOVE
Call For Reinep.
I I Y Or:' 1"103ARD RECEIPT OF PAYMENT RIF-CL-IPT NO.
C.W.rK AMn(Jl\ll' a,). 93
NAME (: AGH AMOUNT 0. 00
ADDRESS PAYMENT DATE a V i /OS/9-",
SUBDIVISION
(JURPOSE OF POY14ENT AMOUNT PAID PURPOSE OF rjAYMFNT AM()IJN*r PAID
MLCHnNTCAL. PE: ;::*.13. 50 E-T. BUILD PIER 1. 43
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13441'a SW 100111
TOIAL AMC'-'NT G,nm 29. 93
NECf-:.')N I LOL
C11YOFTI(FARD PERMIT
CITYOFTWARD PERMIT #. . . . . . . : MEC93-0006
COMMUNITY DEVELOPMENT DEPARTMi-W ORIGON �
13125 SW HJ Blvd. P.0,Box 23397,Tig",OrWm 97 43" /M�qP3) ITS DATE ISSUED: Q,1/08/93
SITE ADDRESS. . . : 13840 100TH i,VL-: FARCEL: 2S102CD-03400
SUBDIVISION. . . . : SWI1.-0 I ZONING- R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .3
CLASS OF WORK. . :AL'T FLOOR FURN. . . . EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRr-,. . :R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES. . . . . . . . : BOILERS/COMPRESSORS HOODS. . . . . . . ..
FUEL TYPES------------ 0-3 HP. . . . -. 1 DOMES. INCIN:
: /GAS/ 3-15 HP. . . . .- COMML. INCINi
MAX INPL,T: BTU 15- 3.0 HF',. . . . : REPAIR UNITS
FIRE DAMPERS?_ : 30-50 HP. . . . : WOODSTOVES. . ,.
GAS PRESSURE. . . : 50+ HP. . . . -. CLO DRYERS. . :
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : l
FURN ( 100K BTUs <= 10000 c f m: GAS OUTLET s. ol
FURN >=100K BTU: > 10000 cfm:
Remarksa OIL TO GAS CONVERSION FURNACE. AIR CONDITIOOER AND WATER HEATER
Owner: ----------------------------------------------------------
YOUNG type amount by date recpt.
13840 SW 100TH PRNT $ 28. 50 JH 01/08/93 —
51-ICI $ 1. 43 JH 01/08/93 —
TIGARD OR
Phone #t
Contractor:
COLUMBIA HEATING
3900 SW BURNHAM
SPACE E-110
TIGARD OR 97223 ------------------------------------------
Phone #: 624-2704 29. 93 TOTAL
Reg #. . o 76359
------- REWIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line I n s p
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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.
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Permittee Signati-treCL,
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Call for inspection E '39-4175