7260 SW SHADY LANE -1260 SW Shady [pane
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City of Tigard Building Department i
13125 811 hall Blve, Tigard, Oregon 97223 I,
Inspection Line (Rec-O-Phone)s 639-4175 Buaineaa Phones 639-4171 C
Innpections
Footing:in Plbg. Underalab Koch. Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gan no rINALs
Pont/Beam Struct. San. Sewer Frar t. -Bldg.
Pont/Beam Mech. Rain Drain Ineu.ation -plumb.
Pltx7. Underfloor Nater Line Gyp. Bd. -Koch.
UTimes _�AM _—PH PN
Dato Reclueetods J �. -- `
Addreen:
Permit #t���1
Builder:
THE FOLLOWING CORRBCTIONS ARE REQUIRBDs
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f
Inapectort ��� -- ---- Dates_y
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Rei.nep.
F..0 H A N 1(,'A L
P ERII I T
CITYOF T'GARD P E R MIT . . . . . . . : IIEC90-0271
�ITYOFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT 01FIGONI 1
SUED: 1. 12:1.190
13126SWHWIBlvd. P.O Box 23397,T1prd,0nvgDn 97223(603)639-4175 1)()TE. 13)
—1 i)1)R L.Ij 0/f2 U W ;:;W S i-1 H 1)Y* 1 1-1 PARCEL: 1S125DB-05500
St
-IDDIVISTO111. . . . ..� SHADY JKA L HO. i-1 7..ONIN(3,-.
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C L A SS 0 F W 0 R K. A 1)1) FL(. ON TURN. EVAP COOLERS
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TYPE OP UNTT 11FATE'RS. .. c vEN r F-ANS. . . n.
0CC11UPAN(:,'Y GRP. . .R3 VENTS W10 APPLS VENT SYSTEMS-
ST 0R I C'S. . .. . . . . .. T4(.11.1.k%R G/C 0 11 F'R E.S G 0 R 3 HOODS. .
FLJ EL TY p-F 6.......................... 0-3 HP. . . . g DOMES. INC IN:
WOD/ HP,,
MAX INPUT: BTU 15-30 HP,. . REPAIR UNITS:
10: 1 k U. r.Wyl p,r:R 1;,:) :30-,S0 111-1. . WOODSTOVES. . r I
GO PRESSURE— . » 50.4- HP. . . . CL.C) DRYERS. .
NCI. 0 F U N T T!3 0I R H n lq D L T N('; U H T OTHER UNITS.
FURN ( 100K BTU: :1.0000 Cfill: GAS OUTLETS. -
FURIN )t-1,001. 1.0000 CJM..
Remia'vksn WOODI:;JOVE.'. PEMIIT
Owi-te-r: FEES ......... ..................... ...........
(::.I F.+. MATTHEWS tyr)e -An)(JL(Ilt b i Y (Jat(i r t--? ., :)L
c1
PO F4OX 23515 POYVI 15. 23 JU4 11/21/90
1::,1:'t(yj 1, q; .1.-4.50
ITCARD OR 9722:3 5 F, 0. 73
F1!1C)1-1e #-,
1'0H'YF,'(1C;TOR NOI ON F"11...E:
................................. - .............
e # 15,, 23 TOTAL
REC41RED INGPEC*ITTONS
This petmit is issued subje,,t to the regulations contained in the Firial .1its ptacLi.oii
Tigard Municipal Code. State of Ore. Specialty Codes and all other ..............................
applicable time,. All wort, will be done in accordance with
......................
Approved plant. This permit will expire if woTk is not started
within 180 days of issuance, or if work is s,!svended for more
than 180 days.
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OF?I'Mi-t-UIP Siq)1,AtUTP
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uekil. i(:)r
"ITY OF: Tirj'i.',RL) RECEIPT OF FAYMENT RECEIPI NO. 90--207C A4
CHECK' AMOUNT 15. 2
MATTHEWS, G. P. CA'SH AMOUNT
ADDRESS
PAYMENT DATE 0 1 ) 21
SUM: WISION
7.20', SHADY LANE
f'URPOSE OF PAYMENT AMOUNT PAID PIJRPDqt,.': OF F'AYMI--':..N7 AMOUNT PA I D
rc- t 4, 51.1 ST., BUILD PER 0. 7.1.:,
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! , , I ,�L AMOUNT PAID
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CITY OF TIGARD MECHANICAL PERMIT Receipt #
13125 SW HALL B LVD. Permit #
P. O. BOK 23397 Description
T I GARD, OR 97223 ( i /�`� Table 3A MechanlLal Code —_ OTY PRICE AMT
(503)639-4175 �J I (� 1) Permit Fee -0- -0- 10.00
Name of Devebpmerq
2) Supplemental Permit 3.00
Job Add nn 1 Furnace to 100,000 BTU 6.00
I Address V`J �t� a )_incl.ducts&vents
~' Tax Lot Map NoFurnace 100,000 BTU +
2) 7'
incl,ducts,8 vents
PAX* iRxtmsitxi
Name(or name of buskiess) Floor Furnace
3) incl.vent_ 6.00
Maw Phos 4) Suspended heater,wall heater 6.00Owner L ' or floor mounted l(eater
aDVent not incl.in
t3 5) appliance permit 3.00
(orrla}ta of brnitte e) '— Repair of heating,refr rig.,
6) cooling,absorption unit 6.00
Mailing Address PhonsBoiler or comp to 3 HP
Occupant 7) absorp.unit to 100,000 BTU
6.00
City/Stale ZIP Boiler or comp lu 3 HP-15 HP - ---
8) 11.00
absorp.unit to 500,000 BTU
Name Boiler or comp 15-30 HP
9) absorp.unit Y2-1 million 15'W
Mailing AddresPtlttrls 10) Boiler or comp to 30-50 HP 22.50
L S absorp.unit 1-1.75 million
Contractor I�tiss L �p -- I 1 Boiler or comp to 50 HP
'7' ) i1 absurp,unit 1,750,000 BTU
Sle Renis aeon No. a. 12) Air handling unit to 4.50
10,000 CFM
I hereby edcnowlertge That 1 have reed this applir;ation that tIu information given is 13) Air handling unit10000 CFM + 7.50
w
correct,that I am the owner authorized agent of the owner,that p ,
plans submitted are in –----
crxnpliance with State laws,that I am registered with the State Ruiklers'Board,that the14) Non portable 4.50
number given is correct (if exempt from State registration please give reason below). evaporate cooler
Vent fan connected -
- 15 to a single duct 3.00
--- ) Ventilation system not
18 included in appliance permit 4.50
17) Hood served by 450
mechanical exhaust
Signature(owner or agent) Date ) Domestic type 7.60Describe workaddition F1alteration I I repair ❑ 18 Incinerator
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to be done residential f ] non-residential I I19) Commercial or industrial 30.D0
Existing use of type incinerator
building or property _ J Other i.e.,woodstove,water
20) heater,solar,clothes dryers,etc. 4'�r
Proposed use of - ---- ---
building or property._ __
21) Gas piping one to tour outlets 2.00
Type of fuel- oil L 1 natural gas C) LPG F1 electric ❑
22) More than 4-per outlet
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON ---- SUB-TOTAL
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 OF 180 DAYS AT ANY TIME AFTER —
WORK IS COMMENCED. TOTAL
SpEdal Conditions
Date issued_ t y__ __