10375 SW HILLVIEW STREET 4
L��L�TS M2IA '?7IH MS SL£QT r
city of T1.c,Tard ►aildl gun —partac+nt
13125 SN Hall alvd• Tigard. Oregon 97223 y
Inspection Line (R�ecc---O-PPh�nnep 63t 41775B.u�sinean Phone- 639-4171
Inspections (. -�4..1r�°--�
Vootirca Plbg. Underelab Mech. Rough-ia Appr/Sdwlk
Fou-d. Plbg. Top Out Gus Line FINAL:
o_.et/Baam Struat. San. Sewer Framing -Bldg.
Post/Beam Mech. Rain Drain Insulation -Plumb.
p1bq. Uw4erfloor Water Line Gyp. Bd. -Mech�
Dr.ce Requested:_ __/
w /� Tiimmei AM
Address:_._.._. 1 �� '� `J u1� Pekbit ft i :j
Buildert
THE FOLLOWING COR P'R.,(20IRED:
r
Inepacto.: Dnte:li
y_AlPb.iNED DISAPPROVED "PROWD SUBJECT TO ABOVF•
Call For Reinsp.
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�LN�P_L_"C--' O NOTICE
City Of Tigard Building Depsrtae_:
-125 Sp gall Blvd. Tigard, Oregon 9''223 �
Inspection Lime (ROC-O-Phone)• 639-4175 Business Phone 39--171
Inspection:
Footing Plbq. Undecelab
Koch. Rough-in Appr/sdwlk
Found, Plbq, Top Out
Gas Line FINAL:
Poet Be
/ am Strutt• San. Sewer
Framing -Bldg.
Poot/Beam Meth. Rain Drain
lnnulat.on -plumb,
Plbg. Underfloor Water Lina
GYP• Bd. -Meth.
Date P.e(lueetedi ..
_l/z2 --I�/
Ti.:bst 1W k+N
Address: ���-) � �� f��
Permit �t--(+'.L/•-_
Bui.lder.:
THE FOLLOWING Cr-.RRC"fIONS ARE RRQU%REDt -
tnRt�ctor - /J/� -/---
Dat R.- j 1 /
APPROVED DISH?PROVED
----- APPROVED SUBjECT TU ABOVE
_Call For Rei.nsp,
x Mir,..
W
MLGHANICAL
C�1�0F710ARD Ciff OF TWAFffi PERMIT
r E-r)1-01 13
COMMUNITY DEVELOPMENT DEPARTMENT _MIT #. . . . . . . : M
(6W)630-4175
13i26hWHW1B1vd- P-O'B'rw.Tvvid,0"-97223 E ' : 07/03/
VIEW ST PARCEL-: 2Sj0LpCC--0l401i'
IIE ADI)kE
10375 SW HILL
ION. FRF-ILEON HEIf1'3HTG -ONING
LOT. . . . . . . . . . . . . : 17
,LOCK. . . . . . . . . . ..
EVAP COOLERS:
LASS OF* WORj<_ :ALT FLOOR FURN_ vk:.i4T FPN`
tj�jj 1, j-jv-.ATEPS-
-YPE OF' USE tSF VENTS W/O APPI-1 VENT SYS(EMS"
.jGL"U1.,ANC Y ORP. Ra 'RESSORS HOODS- -
0-3 HP. DOMES. INCIN:
HP. . . . C()Mmj_ . INCIN,
15-30 Ht"'. REPAIR UNITS:
'JAX I N, 'J 4 LATU 3o-50 HP. . . . wOODSTOVES- - :
T)OmPERS".) CLO DRYERS. . :
504 HP. O'T�,jFR UNITS. . 1
r�AS PRF'.sSURE r4jr, H��IqDLING UNIT"?
1,10, of UNIT"I 10000 cfm : GAS OUTLETS.
FUHJq � 100K BTU11 10000 C-Fmt
rU-Rhj > �'10@K BTU: ODDING GAS HOT WATER HEATER
'ieMSv-kS ' OIL. TO GAS F'JRN(AC'E CONYERSION rEES
—------ t y P e AmoLtnt by datO
GLENN RIPLEY P R MT JL.H 07103191
10375 E3W HILL VIEW G-T1. 13 JLH 07/03/91
5PCT
TICIAPI) OR
OWNER
I OTC41-
PhaTle
rr,r #. . . —-- REQUIRED INSPEcTiOris
ppj,jit is issued subject to the regulations contained in the
arG Municipal Code, Statt Of Ore. Specialty k^odes W all other
Dplic&bll laws. p1l
'"ark will be done in acrardance with
.,
oorove�' plays.
Thit permit will nApire if wo,'6 ie not started ..........
'ithir lot days of istivance. or if work s usoefldt: for more
-14- IN days.
ir)spectiDn 639-4175
MECHANICAL PERW T' Receipt#
CITY OF TIGARD �
Permit #
13125 SW HALL, BLVD.
P. O. BOX 23397
Description
ble,A Mechanical Cod!_— QTY PAiCE _AMT
T I GARD, OR 97223
Ta
(.503)639-4175 ✓ 1) Permit Fee _
-o- -o- 1c.00
Name of Development 2) Supplemental Permit 3.00
Furnace to 100,000 BTU -- 6.00
Job Address _
incl.ducts&vents _
Address _ _
Tax Lot Map No. 2) Furnace 100,000 BTU + 7.50
incl.ducts&vents
got Block Subdivision —
Name(or name of business,}) y ZoO 3) Floor Furr ace 6.00
Vincl.ven,
- 4 Suspended heater,wall heater 6.00
Mai �� Phone —
Owner �� rr ) or floor mounted heater
I
! Vent not incl.in 3.00
Gtyr late[ `�� ` � ZIP5)
7L' 5) appliance permit —
Name(or name of busines ) 6) Repair of heating, u i 6.00
Gaoling,absorption unitt
Meiling Address Phone 7) Boiler or comp to 3 HP 6.00
Occupant absorp.unit to 100,000 BTU ——_ —
City/State _T Zip u 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,0100 BTU _
Boiler or cornp 15-30 HP 15.00
Name� /r 9 absorp.unit'/.:•1 million
Mailing Address Phone — 10) Boile:or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million
Contractor City'Statn Zip 11) Boilar or comp to 50 HP 31,50
—� -- absorp.unit 1,750,000 BTU- —
State Fegistratiun No City Bus.Tax No. 12) Air handling unit to 4.50
10,000 CFM
13) Air handling unit 7.50
1 hereby acknowledge that I have read this application that the information given is 10,000 CFM + _
correct,that I am the owner or authorized agent of the owner,that plans submitted are in - "—
compliance with State laws,that i am registered with the State Builders'Boa,d,that the 14) Non portable 4.50
number given is coned.(If exempt from Stale registration please give reason below). evaporate Cooler
Vent fan connected 3.00
15 to a single duct _
16) Ventilation system nc' 4.50
Included in appliance permit
Hood served by 4.50
17) mechanical exhaust
_ �e—
j signature(owner or apertt) - ` Date 18) Domestic type 7.50
DesC66_yNor----` b addition ❑ alteration ❑ repair Elincinerator
to be do-,a residential ❑ non-residential ❑ 19) Comrnerci;tl or industrial 30.00
type incinerator
Existing use of
building or properly— __ 20) Other i.e.,woodstove,water 4.50
heater,solar,clothes dryers,etc. —
Proposed use of building or or ro ert _
g property Y 21) Gas piping one to four outlets 2.00 _1 --
Type of fuel- oil ❑ natural gas [7 LPG ❑ electric ❑
22) More than 4-per outlet
NOTICE SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- —' 5%SURCHARGE
STRUCTION AUTHOR'ZCD IS NOT COMMENCED WITHIN 180 _
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER TOTAL l
WORK IS COMMENCED. y C
Special Conditions
Date issued _by
C I 7 Y OF TICARD RECEIPT OF PAYMENT RF-CE IP-( NO. :9 1—;l 1501
CHECK AMOUNT n 0. 00
i',IAME s RIPLEY, (31—ENN CASH AMOUNT s 23. 63
ADDRES,; t 10,175 SW HILL VIEW ST' PAYMENT DATE 07/03/91
809DIVISION
I-IoArID, OR 972;,-3—
PURPOSE OF PAYMENT AMOUNT PA 11) PURPOSE OF PAYMENT AMOUNT VIA ID'
..........—
22. 50 ST. BUILD r'i7.,R
1
I-OTAL PMOUNT PAID 23. E,l
gard
"JIGN
for
INSPECTION TIME- PERMIT
DATE ' .J-�-0-- DATE ISSkJED :- I
OWNERS NAME : Z;�
ADDRESS: /6 X74- 94 5Z
C 0 N T R A C TO R
TEST * Air L?, Water [] Visual 0 , Laboratory []
RESULT ' Approvs)d Disapproved C Pending Lj
SKETM'
INSPL-^TOR DATE
NOTE Attach supplemental test data hereto {
BUILDING DEPARTMENT, TIGAR[9 �O '!
PLUMBING PERMIT ju
holder nt a valid plumbing contractors license is hereby
authorized to cause plumbing work as herein noted to be installea in jccordance with the plumbing code of
Tigard. Such installation,; require inspection by the City Inspector who shall be notified riot less than tour
(4) hours prior to the time the installations are ready for ;nspection. City of Tigard Business License required
for all contractors and suh-contractors.
JrD
� ate
�tt I�1 Roo �1,9� �./����1�'�'. Address '1?'�' ,hh���l�_) �'�t� Vl P,.�Y /q
Owner ....._.....
NUMBER OF TOTAL
TYPE OF PERMIT ITEMS FEE ON EACH AMOUNT
Single FsmllY-1 bath-each _ ,—__- _ _. 25.00_-__ -_- -
Duplex-Each 1-.beth unit —
Additional_bathrooms-each _10.00_ - -
Mobile Home Space-each _ _ __ 15.00 -----
INDIVIDUAL FIXTURES COMIInERCTA
1 to 50 Fixtures in 1 buildin -each— _ __- 3.00 - -----
-51 to 100 Fixtures in 1 building--each ��- 2.5G
101 to 200 Fixtures in 1 build'n9-each —__ 2.00 —
_201 or more Fixturee iri 1 building each _ _ 1.50
MISCEL NEOUS
Sewer--each additional 100 f•. 10.0.0
Water Service to au�ldin 5Il0
--� iT
Other 5pecify1 — -----T--
PERMIT �(J uf'I For Phu. bing h0ection Phone 639-4171
(i—� � Piatnbfngt.vtttre^.ter � ....^
__4%6 State By --- —
TOTAL U- C1 RECEIPT NO. / Issued By _ I
PERMIT TO CONNECT
i
Tigard. Sanitary DhArict
PERMIT N9 1045 DAT.,.
PERMIT IS GIVEN TO
OF _---
TO CONNECT A
TO THE SYSTEM OF TIGARD SANITARY DISTRICT
AT
THIS PERMIT MiJST BE POSTED ON THE DESCRIBED PREMISES UNTIL CON-
NECTION IS MADE AND INSPECTION OF CONNECTION HAS BEEN COM-
PLETED.
PERMIT FEE PAIIA $.... ..........................TIGARD SANITARY DISTRICT
By
ew►ws.�
CONNECTION INSPECTED AND APPROVED
Date �~ a�Pcrintendent ����
�a
I
I
7
Address�d3,7,}' % GQ�i Permit No.
1
Name of Occupant_ _ Permit charge -Z
Connection fee .2% .O
—------ - - -------- -- --- Paid by
Date connected /C - z 7- &.7
Type of Building,--(?,, ____ _ _ Inspection fee_ / 0 _
Service Rate----_ Paid by -- _ Date �__-_--
Contractor_-- _ Assessment__
Size of connection
I