16845 SW MATADOR LANE 3NVI Noavivw MS 5b39L
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16845 SW MATADOR LN
TY OF TIFA RD
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-COMMUNITY DEVELOPMENT DEPARTMENT MECHA4ICAL
PER�IT
13126 SW HIM OW P.O.BW=23307,TipM,OrWM 01 (6W)6394176 PERMIT N. . . . . . . i MEC92-0222
6.39-4171 DATE ISSUEDs 09/21/92
SITE ADDRE5S. . . 1 16845 SW MATADOR LN PARCELe 2S116AD--I6500
SUBDIVISION. . . . : ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . .
.—--------------------------------------------------------------------------------
LLASS OF WORK. . :ADD FLOOR FURN. . . . i EVAP COOLERSe
FYPE OF USE. . . . cSF UNIT HEATERS. . : VENT FANS. . . :
ULLUP(ANCY GRP. . :R3 VENTS W/O APPLi VENT SYS TEMSi
STORIES. . . . . . . . 10 BOILERS/COMPRESSORS HOODS. . . . . . . :
[ UL.L 0-3 HP. . . . : 1 DOMES. INCINt
: /UAS/LLE/ 3-15 HP. . . . : COMML. INCIN:
1v1i4X INPUT s BTU 15-30 HP. . . . : REPAIR UNITS:
F- IRE DAMPERS?. 30-5121 HP. . . . : WOODSTOVES. . e
UAb PRESSURE. . . 1 50+ HP. . . . : LLD DRYERS. . i
NO. OF AIR HANDLING UNITS OTHER UNITS. :
f-URN ( 100K BI'Llal <= 10000 cfm: GAS OUTLETS. : l
FURN ) =100K BTU: > 10000 cfm:
Hemarks : GAS FURNACE & AIR CONDITIONER. NOISE READING REQUIRED FOR AIR COND.
owner: ----------------- FEES ----------------
DORIS PLWONKA type amount by date recpt
16845 SW MATADOR PRMT $ 25. e0 JH 09/21/92 —
5PCT $ 1. 25 JH 09/21/92 —
KINO CITY OR 9722'4 MISC $ 20. 00 JH 09/P1/92 -
Phone #:
Loritrac,tort ----------------------------------
COLUMBIA HEATING
8WO SW BURNHAM
SPACE E-110
TIGARD OR 97223 ---------------------------------
Phone #: 624--2704 $ 46. 25 TOTAL
Rey #. . : 76359 REQUIRED INSPECTIO14S
This permit is issued sub'iect to the regulations contained in the Final Inspection
Tigard Municipal Code, State of Ore. Specialty Codes and all other
IL applicable laws. All work will be done in accordance with
ix approved plans. This permit will expire if work is not started
within 18@ days of issuance, or if work is suspended for more
than 180 days.
AW Permittee Iiignature : ACWT.......
Issued By :
Call for inspection 639--4175
SEP-04-192 FRI 12:58 1D:CITY OF KING CITY FAX 140:503 639-3771 tf285 P02
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-------------SEP-04-'92 FR I 12:57 l D C1 T7-T KIFb Cf-TY FAX N0:503 639-3771 0285 P01
Pont-tt"brand fax transmittal memo 7671 00'P"" '
SING CITY -
Co r
1 16W$W,116th Avenue,King City,0rrRnn 9 Pao 11hon,
COMMUNITY r , 7A2 9 F"
APPLICATION FOR 8 �-----
(laetrnctionl
DATE ` � ' •� }� one Na.
1. NAME OF AFP '—
ADDkF.,9° Sr
ADDMG OF PRDFOSF.D —
2. TYPE OF MANGE, IWROVUUI'TI' OR C70NS'TFt►3C110N FOR thflCH pMIT 19 RDQtyFb'L'Fn.
DESCRIBE BRIalLY -.A WFIEs OR PLM8.0 t
3. NAME MM AD F
ole Scfl , %mss PH= NO. ,IcEiSE •�r%� ----
4. NEI(lFIBC)RS WHO MAY BE MT(-
M BY THIS PROJECT WILL AE NOTIFIED BY THE CITY.
APPLICANT OR HM/H18 RFSPES 1t'1'I'ATIVE MUST IBE PREBI? r AT THE PLANNING! 0Cf'M188I0
N
MEETING NEXT HELD CYt � •
REPRF,SENTATIVE9 NAMF,--
(the ling Cit, pleanial oetlisnion till tot last only those gplicltioas reeti.�d at. leant titre (S) dais
prior to a Ikeeti5I.) , '
SIGNATURE —
***�e,recta*ir�t****�*�ir�t******tsrrttt I**-erg
APPLICATION R MIVED BY` �R-C_�`-`�� Q -7•�9` �1 E31� TF,- t —
APPLICABLE FES ROCEIVID
PLANNING! OOMISSION D ETON: rov
001NDITI S
Al'ro applica is s lid for it Ikon ly
i Signat Date
i ISOTt:
10905110 yrs ee require$ that all persoas who contra for ork on Bell residence be
registered lith the Builders 101rd which Ikeene the tootractor is banded and insured on the job Site.
1L for your protection, be certain iaar coetrartar is Iegietered by tailing Citi will ph: t;lg•4011.
QC
H
iNG71'L: A permit trust also be obtained from the City of Tigard Department of
m CwrwMity Development Yes, -
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gu OF TI- DINSPQCT-__J-0"- M
The above listed project has been inspected and Approved-----Pe►ied,—
Date_— Camr�nts__.
signature_,,_ RrQ.b1M Mt 11) copy *o KAM MY)
(��r i�ta►pt�eate+t- �°,esr
f CD 2-17