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INSPBCfION NO'.tCE
Zity of Tigard Building Department
13125 AM Nall Blvd. Tigard, Or 9722?
Inspecti.oa Line (Rec-O-Phone): 639-4175 Business Phone. 539-4171
/
InepectionF ��'--�---
Footing Plbg. Underulab Mech. Rough-in Appr/3dwlk
Found. ?lbg. Top Out Gas Line FINAL:
Pwt/Beam Jtruct. San. Sewer Flaming -Bldg.
Post/Beam Mech. Rain Dratn Ineulatior -Plumb.
Plbg. Underfloor water Line Gyp. Bd. 460th _
f
Date Requested: - Tis AMPH
Addreee: �f U it
Builder: �� ��,, ----
THE FOLLOWING OCMMCTIONB AR! MQOIRED:
Inspector: —_� Dates_ /�3�
V APPROVID DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinep.
INAPECTION NOTICE
Cityof ligand Building t>pipartaot
13125 SW Hall Blvd. Tigard, Oreqon 97223
Inspection Line (Ree-O-Phone): 6.39-4175 Bunineas Phone: 639-41-1 1
Inspection•_
Footing Plbg. Underslab l;ech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out f4as`Lin� FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Pont/Beam Mech. Rain Drain Insulaticn -Plumb.
11bg. Underfloor. Warst Line Gyj% Bd. -Meeh.
Date Requested e '65. /~ —Times / /`. AM PM
Address.��/l
t)
Builders
THE FOLLOWING rORRE1.71ON5 ARE REQ'.IRED:
(�1 'S 0 PP-2 X-r– -QQ J,S 1'-Z" Q 6) (f=�Ji, Merl -
V"—rl`/)L GA i/a C.=a r; -T� =z?rr►4
vn..J ii1tST/J1,1_ATi,�•�_j
Inspectors _ _. Date?
_APPROVED DISAPPROVED PPROVED SUBJECT TD ABOVE
_ call For Reinep.
:': IR !!
CITYOF TIGARD I McCHAT.1CAL
' PERM 1'T
COMMUNITY DEVELOPMENT DEPARTMENT cnvOFT*ARD PERMIT # • • MEC91-11105;.:
MOON
13125 SW Hell Blvd. P.O.Box 23397,Tigard,Oregon 972 (603)1130-4175
-- - -- - DATE IG 73L1ED: 03/20/91
l
IE ADDRESS. . . : 10470 SW 67TH AV FARCE►..: iS136AD-010700
rSUBDTVISION. . . . : !J•ILl_A RIDGE NO. v ZOhIIIrIG: R-�r•. G
EILUCK. . . . . , . . . . . LOT. . . . . . . . . . . . .
CLASS Or WORK. . :ALT F=LOUR rURN. . . , : EVAP COOLERS:
TYPE OF USEw. • • • :SF UN IT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRI=,. . : R3 VENTS, W/O APDL: VENT SYSTEMS:
S T OPIES. . . . . . . . . POIL.E".RS/COMPRESSORS HOOD . . . . . .- -
DUEL 'F'YF'ES--_.—_______.___ 0-3 lap. . . . : DOMES. INCIN:
HP. . . . : COMML. INCIN:
�lf4x INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
1"-'IRE DAMPS RS' 10-•5.101 HP. . . . : WOOD JTOVI S. .
GAS PRESSURE. . .
504 HP. . . . CLO DRYERS. . :
OF 140. F UNITS _.—__.__...__._...._.._ t4I R HANDLING UN I TS (--,THwR UNITS. : 1
l'I..IRI\I ( 100K BTU: tw 10000 cfm : CTAS OU'fI.ETS. :�
`TURN >=100K BT'1_�: 1 > 10000 r f m r
?emarks : GAS FURNACE AND W 47'F k HEATER
FEES ._.—... ......_.._.._.._„--
LIN'-)A MILLER type ��n. Ant by date rer_pt
t 0470 1;14 E 7TH AVE ''NYhI t 25. 270 JLH 0312Q'; q 1
TGARD OR
PRMT , 24. 00
�1'l ;_ ;
::yF C.7 1. 4:0
� 'h��re #i:
LUMBIA HEATING
sy4i 0 SW BURNHAM
)PACE 1:•-1 10
WARD LIR 97223
'hone #: ,24—L'704 2;;. u17rTC)"TF:�L—�._.
eq #. .
REQUI REL INSPECT IONS
^is ptrait is issued subject to the r!gulations contained in the Final 7 r1:,c�r�c t i on
igard Municipal Code, State of C e. specialty Codes end all other
cplicable laws. All work wili be dine in accordance v4t"
appro'ed plans. This ptrait will expire if work is not 5tarteJ
.;ithin 180 days of irsuance. or J work is susperded fcr sore - .--._--
han IN day;.
m i t t d e !i i rl n a+.
Call for inspection - Eu9-417a
Vol
CITY OF TIGARD RF'rFIPT OF PAYMENT RECEIPT NO. 91-e'109 36
CHECK AMOUNT 25. rI2l0
E t.jMp CpS�j AMOUNT 0. 00
10)M
lA HEAT PAYMENT DAT"E c 03/20/91
AUORES:, sUBDIVISION
10470 SW 67TH AVE
PURC-OSE Or ?AYMENT flMOUNT PAID PURPOSE OF tYMh idq AMOUNT r.-.In I D
ST. 1 . 20
MEC,9 1-0052 24. 00 BUILD PER
-m-FC-5—,A i -1-C"1-4 —P—F
GA I r
TOTAL '1140UNT
i
i
CITY OF TIGARD MECHANICAL (PERMIT Receipt#
13125 SW HALL BLVD. Permit #
P. O. BO'_ 23397 / Description
T I GARD, OR 97223 s J ..,y,/� � Table 3A Mechanical Code CITY PRICE AMT
(503)639-4175 / l ./r, 00 7 1) Permit Fee -0- 10_00
Name of Development 3.00
2) Supplemental Permit i
Furnace to 100,000 BTU 6.00
Address i4 �,_ i%
Job Address ' 1� incl.ducts&vents
�' '_ __-
Tax Lot Map No, 2) Furnace 100,000 BTU + I 7.50 , ST
incl.ducts&vents
Lot Block SubdivisK,n
Name(or nuns of businennss) 3) Floor Furnace 3.00
incl.vent
Suspended heater,wall heater 6.00
Own::r 1n Mldn�� h r 4) or tloor mounted heater _
cityistate Zip 1 5) Vent not incl.in T.,3.00
i appliance permit
L&VII- N or name busifteu) 6) Repair of heating,refrig., 6.00
cooling,absorption unit
Mailing , cess pho,a 7) Boiler or comp to 3 HP 6.U0
Occupant absorp.unit to 100,000 BTU—_ _
CItyVState Zip 8) Boiler or comp to 3 HP-15�iP 11.00
absorp.unit to 500,000 BT J_
- Na9) Boiler or comp 15-30 HP 15.00
absorp.unit /z-1 million
Iliny Address ; y 1 Fhone 10) Boiler or comp to 30-50 HP ?2.50
I �il� �.., i t absorp.unit 1 -1.75 million
__'tel -
Contractor � Boiler or comp to 50 HP
city/Stell zip +) p 31.50
t . �-�� absorp.unit 1,750,000 BTU
State n Istration No. City Bus.Tax No. Air handling unit to 4.50
c� rr 10,000 CFM _
Air handling unit
1 hereby acknowledge that I have read this appik:dlon thmi the information given is ( 10,000 CFM + 7.50
correct,that I am the owner or authorized agent of the owner,that plans SiO'-'„ad are In
compliance with State taws,that I am registered with the State Builder Board,that the 14) Non portable 4.50
number given Is correct (11 exempt from Stsf.+regish atlon please give eason below). evaporate Cooler
15) Vent fan connected 3.0G
to a single duct
16) Ventilation system not 4.50
inch ided in appliance permit
< Food served by 4.50
I 17) mechanical exhaust _
91g s1u low net w agent) —�- -- _ Date 18) Domestic type 7.50
Describe wo-k 1-1 addition ❑ alteratiorVU repair ❑ incinerator
to be done _ residential _non-residential ❑ 1 g) Commercial or Industrial 30.00
type incinerator _
Existing use of ”
building or propurly `0) Other I e''woodstove,water 4.50 ,5 Z'
heater,solar,clothes dryers,etc.
Proposed use of
building or property_ — 21) Gs--piping one to four outlets -:.00 Zlf if)
Typo of fuel- oil El natural gay LPG electric ❑
L 22) Mara than 4-per outlet
NSE SUB-TOTAL
THIS PERMIT BECOMES) NULL AND VOID IF WORK OR CON-
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 Or 180 DAYS AT ANY TIME AFTER --� -� TOTAL
WOFiK IS COMMENCED I
Special Conditions
Date issued__ by —_�-