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NSPEC- ION NOTICE
City of Tigard Building Department
13125 BM Ball Blvd. Tigard, Oregon 97223 /
inspection Line (Ree-O-Phone): 639-4175 Business Phone: 639-417 -
1
Inspectiont_
Footing Plbq. Underslab Nech. Rough-i}: Appr/Sdwlk F
Found. Plbq. Top Out
Poet/Beam Struct. San. Sewer Framing -Bldo. C
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Post/Beam Mech. Rain Drain Insulation -plumb.
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Plbg. Underfloor Nater Line, Gyp. Bd. I
Dnte Requested: Ti":
Address: �V yy 1"�i � �I iii Gam. e
Builderr�
THE FOLLOWING CORRECTIONS - RRQVIRED:
inspector I
APPROVED DISAPPROVED _ APPROVED SUB.iECT TO ABOVE
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��Call For Reinsp.
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CIT. TIVAlaw" Tclny
IME(:HAIVICAL
F'ERM I'TCOMMUNITY DEVELOPMENT DEPARTMENTwKoon � PERMIT #. . . RMI : MEC.9 -klc 30
19125 SW Hd18W.P.O.Sm 2=1,Tigami,Orwaon 9-1223(603)6.95-4175 t.
639--4171 DATE: ISSUED: 09/11/92
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SITE ADDRESS. . . . 15486 SW SUMMERFIELD LN PARCEL: 2SIlICA-02800 �
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COC V I S. . . . . . . . SUItII�IE RF' TD. IVU. 7. . . . . . . :37`�i ZONING: R-7
------------- ----------------------------------------.__.__.__-----'-_ _____- - =___-•----_____ R'.
CLASS OF WORK. . :ALTFLOOR FURN. . . . EVAF COOLERS: a
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . :
ULGUf-'FINCY CARP. . s R3 VENTS W/O AIT='p'L: VENT SYSTEMS: N.
STORIES. . . . . . . . s BOILERS/COMPRESSORS HOODS. . . . . . . :
f-ULL TYPES------------ 0-3 HP. . . . : DOMES. I NC I N:
:/(3AS/ / / 3-15 HP. . . . : C01111L. INCIN- 5
MAX I NNUT s BTU 15-30 HP. . . . . REPAIR UNITS:
FIRE DAMPERS?. . : 30-50 HP. . . . WOODSTOVES. . :
UH6 PRE_SSURE. . . : 504 HP. . . . CLO DRYERS. . s
NO. OF UNITS------------ AIR HANDLING UNITS OTHER UN I i 5. :
FURN ( 100K BTU-1 (- 10000 cfm: CTAS OUTLETS. , 1 ( '
FURN ) -100K BTU: > 10000 c f m:
Remarks: GAG CONVERSION
Owner ------------------------ ---------•------- FEES
AVIS WATT type emoLmt by date recpt
15486 SW SUMMERFIELD PRMT 6x_'5. 00 JH 09/11/92 -
5PCT 6 1. 25 X-1 09/11/92 -• ;
f IGARD OR 9724 LI L:
Phone #: �1� t
----------- ----------------------
GDntr^actor: t
MIDWAY HEATING CO
12625 SE SHERMAN
4
PORTLAND OR 9733 ----_-----+---_----___--.------------I
Phone #: 252-4003 6 26. 25 TOTAL
Reg #. . : 24044
-------- REQUIRED INSPECTIONS
This permit is issued subject to the regula+ions contained .t she Final Inspection
__ a
Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with ��-
approved plans. This permit will expire if work is not started
within INdays of issuance, or if work is suspended for more
than 181 days. - -
4.
Permittee Signature:
I 5 s�-red P y.
Call for inspection - 639-4175
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CITY 10F TICARD MECHANICAL. PERMIT Receipt #
Permit #
Description )
Table 3A Mechanical Code OTY PRICE AMT
City of Tigard — -------�- -� �
1) Permit Fee -0- -0- 10.00
13125 S.W. Hall Blvd. — !
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
v®I
639-4175 Furnace to 100,000 BTU 6.00 / W
1) incl.ducts 8 vents L °
Furnace 100,000 BTU +
2 incl.ducts 8 vents 7.50
-- Floor Furnace
Name of Deveto mens 3) FloincVent 6.00 ` I
a>
Job Address 4 Suspended heater,wall heater 600
Address g/ ) .
or ! III
Tax Lot Map No. 5 Vent not incl.in 3.00
Lot Block subdivision ) appliance permit
Name(or name of business) 6) Repair of heating,refr ig., 800
jvk'az�- cooping absorption unit
Mailing Address Phone 7) Boiler or comp to 3 HP 6.00
Owner EG ty' �' absorp.unit to 100,000 BTU
I
ury state 6y zip 8) Boiler or comp to 3 HP-15 HP 11
.00
f7.Z1 absorp.unit to 500,000 BTU —
Nam9) Boiler or comp 15-30 HP 15.00
�G absorp.unit 112-1 million
Mailing Address Pnune 10) Boiler or comp to 30-50 HP 22 50
�S absorp.unit 1-1.75 million
Contractor d b �Sl S/�D Boiler or r:Om to 50 HP
cny site zip 11) absorp.unit 1,750,000 BTU 31.50
4Q 72 Air handlingunit to
State Registration No. City Bus.Tax Mo. 12) 10,000 CF4.50 1
ay0'r)/ 17 -0
Y hereby acknowledge that I have read this application that the information given is 13) Air handling unit 7.50
10,000 CFM +
conect,•rhIlGnaurncc.ac rxa.that plans submitted are in
compliance with State laws,that I am registered with the State Builders'Board,that the 14 Non portable 4.50 !
'I
number given is correct (if exempt from State registratinn please give reason below) evaporate Cooler
15) Vent fan connected 3.00
�- - to a single duct
Ventilation--------- -- ---- - --- -— - Included in system not appliance permit
18) 4.50
17) Hood served by 4.50
mechanical exhaust
Signature(owner or agent) `� i Date Domestic type
Describe work El addition [7 alteration repair El18) Incinerator r 7.50
to be doner i n i l
es de t a ❑ non-residential ❑ 19 Commercial or Industrial 30.00
type incinerator
Existing uss of
building or properly20 Other i.e.,woodstove,water 4.50
Proposed use of
heater,solar,clothes dryers,etc.
(� y2,•,>
building or property 21) Gas piping one to four outlets / 2.00
Type offuel- oil ❑ natural gas LPG ❑ electric ❑ t
22) More than 4-per outlet ;a
NOTICE -
li,ll
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON Xis go SUB-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4%SURCHARGE /, 4D
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL IIis
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. _ TOTAL ,�y
Special Conditions
—_ Date issued ._ by II
I
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