12215 SW SUMMER STREET MIMI
12.215 SW SUMMER STREET
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-SU-49TION !L01 C_E
City of 'Tigard Building DepartsmOnt ?
13125 an Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phones 639-9171
Inspections!_ ------ -- -
Footing Plbg. Underslab ( Meoh. Rough-in %pVr/Sd,r1k
Found, Plby. Top Out One Line FINAL:
Poet/Roam Struct. San. Sewer Framing -Bldg.
Post/Beam Mer-h. Rain Drain
Inaulaticn -Plumb.
Plbg. Underfloor Water Line %YF• ad. -Mech.
h cT t'
IM AN YM
Date Reyueeteds_ I —Fi
,�
Address:_
-r-mit #:�
Builder: :274i)_,,2�s
THE FOLLOWING CORRECTIONS ARE REQUIREDS
Al
l�v„r�•c`.x�r- —r—� �iT��l/aC�__ x,50 _c,�,qTE_�
Inepeoto Dates
APPROVED DISAPPROVED `_. APPROVED SUBJECT TA ABOVd;
Call For Rialn.p.
W
ii
®�� TIGARD MECHANICAL
CRYOF i16
mini PERM vr
COMMUNnv DEVFLOPMENT DEPARTM!qNT MOON . . . . . . .
13126 SW Hell Btvd. r.-,.Box 23397,Tqiud,Or*W)n 97223(503)630-4175
14
SUMMEP ST -00600
.1 2r- Z.1W 1� PORCEL: IS134CS
_',UVrj T;,' T :ION.. SUMMER H1 LLS PARK Z 01\1 J NG: R-4.
. . . . . . . . . LOT. . . . . . . . . . . . . 4
CLLASS OP WORK. -ALT FLOOR TURN. . . . : EVAP COOLERS:
TYPL OF USE. . . ',F UNIT HEATERS— : VENT FANS_ . -
UCLUPANCY GRP. t R3 VENTS W/O APDL: VENT SYS rEMSi
). . . . . . . . RESSORS
ST OR 11--..' POILERO/COMF" 5 HOODS. . . . . . . .
FUEL 0-3 HP. . . DOMES. INCIN:
GAS/ 3--175 HP. . . . - C'UMML, TNCIN-,
MAX INPUTS BTU 15-30 HP. . . . i REPAIR UNITS:
IRE P41MPER5? -.0-50 HP. . . . WOODSTOVES. . :
AS PRLSSURE. . . 504. HP. . . . CLO DRYERS. . :
0., OF AIR HANDLING UNITS OTHER Uhl ITE3.
JRN < 100K bTU- .1 f~ 10000 GWS UUTLE'rs.
URN !OOK L)TU.* i 10000 cfm -
GAS TO GAS FURNACE
FEES
1ANCY Cl�;IJRSIJI_LK type AMOUnt by (late
-215 SW E3UMMER S1 PRMT $ 16 - 00 JLH 05/28/91
5P(."r s i. B0 JLH 05/ O/C,
hlnrls #:
OR
otitt-ri(-tor:
1W PLUMPING SERVICES
G BOX 1112206
MILWAUKIE OR 97221:'�'
17111anp #: $ 16. 80 TnTAL
)eq 0. 61947'
REQUIRED I NSPECT I ONE)
nis oprut it It-vied sub)frt to tne regulations contained in the FiTial Itispection
-igard Municipal Code, State of Ore. 50#cialtv Codes and all other
applicable lAws. All worN will be done in accordance with
-ocroved clan. . This perv)t will mire if wort, is PO la,"
-,itt,in !Po 1ays of issuance, or ;n@napt, �� F % ._._._^.._._._.__._.._._=�_�_ _ _���_....."
than IN aays.
Lall fov-, ins Ller-tion 639-4175
old
CITY OF- TIGAPD -- RECEIPT OF PAYM \11RE=CFTP-r NO. 1 .-'21,3670
CHECK AMOUNT : 16—jo
NAME a COUJMFAIA NW HEATING, INC CA t1-4 AMOUN T o LA. 011,
ADDRESS : V"o BOX 953 POYMENT DAIE t 05/C,8/91
SCAPPOOSE, OR 97056-- S(JBDtVISION
PURPOSE- Of' PAYMEN"r AMOUNT* PAID PURPOSE OF DAYMENT AMOUNT PAID
MECHANICAL., PE 16. 00 ST. BLJIt.I) PFR 0. 60
11i::215 SW 1,,0MMER ST
TOTAL. AMOUNT PPTV 16. 80
SES R, R L�� ff
Jejunif ieSewerage Agency /.rirGl,
of Washington County C I FY OF Q DATE
OWNER _ C�"'", , > 1 f tl��2�"'' P H ON E :_Co -73 6
OWNER ' `_; ADDRESS : � �Z•2 /�'� �� �G�y���L_�� _ _.
TYPE OF INSTALLATION :
BUILDING SEWER ❑ BUILDING SEWER AND SIDE SEWER
TYPE OF OCCUPANCY :
❑ NEW LA SINGLE FAMILY ❑ COMMERCIA.I_
EXIST. (PRIOR TO 7- 1-70 ) rj MULT. RES. ❑ INDUSTRIAL
FIXTURE UNIT/SS D4ELL'r`!G UNITS���_ _
ADDRESS OF STRUCTURF : ZIam
PERMIT CONDITIONS: THE APPLICANT AGREES TO COMPLY WITH ALL RULES AND
REGULATIONS OF THE UNIFIED SEWERAGE AGENCY. WHEN CALLING FOR INSPECTION ,
PLEASE REFER TO THE PERMIT NUMBER, . THIS APPLICATION EXPIRES IN ONE-
HUNDRED AND TWENTY ( 120 ) DAYS. THE AMOUNT PAID WILL BE FORFEITED SHOULD
EXPIRATION OCCUR .
FEES :
PERMIT FEE �
SCD
CONraECTION CHARGE
SIDE SEWER Ir,ISTALLATION
OTHER A �W4W60X _4 3rD a _ TSSUED BY —�
TOTAL
APPLICANT DATE-
t
ADDRESS OF STRUCTURE
TAX MAP �S , � TAX LOT 6OUSYSTEM
-----�- �_._. _
LOT BLOCK —_---- O F 4Y f�L�► _i_ _ -____
FRO E BY DATE(, ISSUED BY DAT,E,,j_�,
D. U . ' S _ REMARKS YGt.+t( �- IA( Qxls�� 5'®h�lG �Cjt ,, Qr. ✓10�'''VG,
i
i
Receipt#
CITY OF TIGARD MECHANICAL PERMIT
Permit#
13125 SW HALL BLVD. =P. O. BOX 2 3 3 9 7C Description CITY PRICE AMT
Table 3A Mechanical Code
TIGARD, OR 9 '223 /s , 3 oC /QZ
(503)639-4175 1) Permit Fee 0 fl- 10.00
Name of Development 2) Supplemental Permit 3.00
Address Furnace to 100,000 BTU 6.00
Job C' incl.ducts 8 vents
Address 17 L �� ��' �'������� _
T Lot Map No. 2) Furnace 100,000 BTU + 7.50
incl.ducts&vents
Lot Block Subdivision
Name(or name of busines i 3) Floor Furnace 6.00
157 incl,vent
Suspended heater,wall heater 6.00
Maui PhOf1e c 4) or floor mounted heater
Owner -jC�, ��cN�N1�'�-.- -- -
Vent not incl.in 3.00
cnyistate ZIP 5) appliance permit
eme of business) 6) Repair of heating,r3fr ig., 6.00
Name
cooling,absorption unit
Mail,�c ddress phone 7) Boiler or comp to 3 HP 6.00
Occupant absorp.unit to 100,000 BTU
Zip 8) Boiler or comp to 31 W-15 HP 11.00
City/State unit to L)00,000 BTU
Nae 9) Boiler or comp 15-30 HP 15.00
'� absorp.unit IA-.1 million _
�)�, � Boiler or comp to 30-50 HP
M Ging Address hone 10) 22.50
absorp.unit 1 1.75 million
Z t Boiler or comp to 50 HP
Contractor City/Stale zip 11) 31.50
�. c�^1c>5r�, absorp.unit 1,750,000 BTU -
Siete Regis at n No. City B1us.lax No. 12) Air handling unit to 4.50
� \�1� .2 10,000 CFM
Air handling unit 7,51,
1 hereby acknowledge that 1 have read this application that the information given is 13) 10,000CFM + _ I
coned,that i am the owner or authorized agent of the owner,that plans submittal ars In Non portable f
compliance with state laws,that I ar,registered with the State Builders Board,that the 14) P 4.50
number given is correct.(It exempt from State registration please give reason below). evaporate cooler -
15) Vent fan connected 3.00
to a single duct
16) Ventilation system not 4.50
_included in appliance permit
—�' 17) Hood served by CG0
mechanical exhaust _
Signature(owner or agent) r Date 18) Domestic type 7.50
Describe work ❑ addition ❑ alteration ❑ repair ❑ incinerator
to be done residential ❑ non-residential ❑ 19) Commercial or Industrial 30.00
-- type Incinerator
Existing use of Other i.e.,woodstove,water
building or properly _—_ 20) 4.50
heater,solar,clothes dryers,etc.
Proposed use of —
building or property_ -- 21) Gas piping one to four outlets 2.00
Type of fuel- oil ❑ natural gas ❑ LPG ❑ electric ❑
22) More than 4-per outlet
NOTICE i SUB-TOTAL ' �O
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION5%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 160
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR P1 AN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
TOTAL
WORK IS COMMENCED. �)
Special Conditions -
Date issued_ by-- — —