Permit CITY T I G A R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00541
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/4/03
PARCEL: 1S135DB-05600
SITE ADDRESS: 11400 SW 95TH AVE
SUBDIVISION: MILLER ZONING: R -4.5
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
OIL 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install oil boiler.
Owner: FEES
WINTER, STEVE Description Date Amount
11400 SW 95TH AVE [MECH] Permit Fee 9/4/03 $72.50
PORTLAND, OR 97223 [TAX] 8% StateTax 9/4/03 $5.80
Phone: 503 612 - 4553 Total $78.30
Contractor:
FIRST CALL HEATING & COOLING
1650 NE LOMBARD
PORTLAND, OR 97211 -4798 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 102030
This permit is issued subject to the regulations contained in the 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 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699
Issued By: �� PermitteeSignature: 71 ��—
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
SEP -03 - 2003 WED 09 11 AM FIRST CALL HEATING FAX NO, 503 286 5194 P. 02
. 4
Mechanical. FORO>HFICeluscoNLY
t eccived Mechanical
Date/Dy: 3 ... , _Permit N ^ ;mEC1,03 — 175` /
Planning p•-royal liuildiing
Carly of Tigi1M'd 1)atc/B _ � Other PLrnuit No.:
S EP 0 3
i 312 ;3w ['Ian ill�•ti. 2Q Plan Review
'1•iLattl, (7rvi;on 97223 D;url3 , .__..- Permit Na.: , -_,., .. -_
Filmic: 503 - (3f) •4171 Fax: 503.50111907 TI Poct•Review land Ilse
t , BUILDING DI �'f Conta ct': Mt: ;�;,f, aN , ,1
Itilexr .t: www.ct,(i(,aril,nr.tts �'! Case N _..
a, Contact Juris.: pi See F;tie 2 for
21 b ur I 'nvh �.Iton ltequt•s1 503 - 639 -4175 "'' Nannc/Mclhntl: /Ca pjilomt+ntallarpt'tnaliuil
TYPE, Or WORK ' ' , ,.• . __ _•. COMMEVCIAL FEE, S(..,:IIED1J1,F: -11SE CH (' :CK i ,15 i'
] Ne;tv t`tnnr.Erucaltan _[: J Mechanical permit fees* are based on the total value of the work
Atitl /aitcrtttictlt /icitiacen1cnl � C)iher: - performed. indicate the value (rounded to the nearest dollar) of all
;, t'A'1'1;irt1ltV OF (;ONti'1'tZUC'1`ION ' _ mechanical materials, equipment, labor, overhead and profit.
l 84, ?_- J 1 . tinily t liti! LI (otnnit rcial/irtdustrial c1 $ �� See P.rpc 2 for t Schedule
hrd
VaI f ule
I IVEIRI :1E,1►r Y_TZ111 ... _it1i!►�; _ n Multi- Z`i1121i1y vI ^- - . _ ESIDEN'f1A1,1'_QU1PMEN /SY,Kri'.A ti(.liil ?
. ... .. _ _ . . M .. T Description —� 1rt
(? c(en.) 7'otnl
A r 1Zu l l tict _ [] Other: _ _ " _ . _ Ilestiny/C nt inj; j - I - .
. ., „ jt3lt st's•I IN I:OI11NA'1'ION and t.C)CATIO furnace- add -o nir cnuditioning ** 14.00
J (t
i: tiddu.. ", 1/4C1 Ld i -4- Ci;ts pump _ _... - 1
Du ct work 14 •
;suite /l: i 131d .'. /A tN. ,.. 14.00 .— .._ ,........
v _._ .... ......... _ _- _J _._. .P w. lrydronichotwuter stern 14.00
h'iOjCGL N:uYit': -
_. _ ... -- - .... - . •. -- Residential boiler
('i o•,s sh r et /•I.)ir 't Lions to job site: for radiator or hydronic system) 14,00 . r •
Unit healers (fuel, not electric)
(in wall, in -duct, sus ended, etc.) � .. ,, _- 14.00
line/vent (for any of above) � _ „ 10.00
,
llxlivisitm� -- . _ - - ---._ .,.._ ^ - For fit :_ - - Repair units _ 12.15
l -- •••• - - Othe1 Puri Appliances _ „ -w -�
'fax tnt11 4: _.. ' - Wale nc�tticr - - T _ _10 _ ,,_ .- --
. lii S( RRHri'iO�v \YORK _ Gas fireplace 1000' --
_ .145`..'4 1, _. _ !l''�.. s /_ _ _ . V 01 Le..! ._ _- Flue vent (water letcr.(`A fireplace) .., __ -
1,og li�htcr (gas ,),,, ��.., 10.00
_._. _ ._ .. . , . , .___ _._.... ,- , . --------- -, . - Wood/J'cllct stove .. -_ �„ . _ 10_00 --
. _..,- ..._._.. ., ,,.._ _� ,, yooditeplacc /inscn _ - _ - 10
,,Chirtlney /liner /flue /vcni „ 10
Nd,[ttii'1•,lt'i'Y tfWiNJ':It ; - rri r.NAN'r aims 10
�ii11110: Environinenull FXhaust & Ventilation
'!� -, I r� � - - .- R ange h oo d / other kilchcn equipment 10.00
#
Clothes dryer exhaust (: s 10.00
y /.SStlll /ri1�_ ._0 .._ c7.� Single __.... •.
1'I uN1t:: Pax: _ (bathrooms, toilet compartments,
(� A i9 "I,lt 1N'[: _ .- �.a C 1?(.ftSON M utility roomsL - _. - _ ..•„_ _ - 6.80 _._„ --
7111110: Attic /crawl space fan;; .
,.,,, _,
.._..._,. --._•. _, ...-. -._,. ()thee: _._...,.. ;; 10.00
�* _ Fuel
C:ily' /S1111c/ tp: ^ ^'- _-- -_, - T t* f first 4, $1.90 catc atlli0ona� . . -
Furnace, etc. +*
l'iultic; _ I�a: Gas heat pump -- - - • M_ ___
r* — —
1?-mail: ^ - -� - -_., .. •_� Wall/suspended/pit, Ft *4
'- C'()N'I'RAt"1'0K .. Watcr heater '.'__
lIttr,incsrc Ntu11C: "pr . t I a e Rj of � /44 fir _ . -. -. . _ .�w
'AtlitiVSSt Nr bpi _ Ranilc .. _ ** . .,.._..�
tall
C tt ' /S ( ab,• / Zip. e +. i .� -• , g — 'i r 1 i -
ltzll � Clothes dryer its) "" —
1 4/, ltw< _I ha _. 6. _, Other: . ,. _ �` *., _ -
- -. - -•-- -- - Mechanical Permit Foe _, ,Z_L . _� -.
Aufllurim'I - Subtotal: $
4tt;,ltltuii: r► hu1C •,�-�- M ' u � ... _ _ - -.
- — -
Minimum Pt rntit Fee $72.50 S
.^ ,
Plan Review Fee (25% of Pei mil Fee ) $ -_ ..
i1 ”' • State Surch1t ar c (8% of Permit Fce S
(Please rett B name) _.......__._ ,..........,_
_ TOTAL 1'siltMl'1' FEE I
-
Notice; This Ail nut Application cirirea tf A permit is not Ohl.,ined within *bee uaelbodnlory set by 'Fri-County follding soda +try Serviee Board.
I110 dnyi oft•a' !La been accepted Ai complete. * *Site plan required for exterior A/C: units. G
r\1 r71 cirri :i Iu
k n\Mrc,1'cnnilApp,'oe 01/03 D
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested / 0 — A PM BUP
Location /I4 75 A-qe- Suite 4 2, 3 -ddsil
Contact Person 0-eo n Ph ( ) 642 — 4 05 - 53 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ✓ V1/\ .01 . ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear ae�
Framing ri-e
Insulation
NIP(/ 1 Q o� 4(p _ / ��� - �` J
Drywall Nailing II `� ` `,
Firewall G 1 ;1■W r:' OZNIARW"15' -11)*)
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: —
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
i /d / !
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam ' V
Rough -In V
Gas Line 6 t f7 L-D �1 ,� a - V-, E 3..o 6 VtiAn
Smoke Dampers , `
final
PART FAIL
EL CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for rein section RE: 4s. n Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector hAj Ext
Other:
Final DO NOT REMOVE this inspection record from the ob site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Linea (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/�
BUP
Received Date Requested /0 — c PM BUP 1/J
Location /(q n 0 J Ak) Suite ME .0 0
Contact Person 4`1. r( Ph ( S U 7) 2 4 .4 2 Ze 74LM
Contractor / S t CA I ( Ph ( ) SWR
BUILDING Ten. ne 5- 1 -e_47e 647/7A._ Sta4/ ELC
Footing 50 — / 2 SS3
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Drywall 0\\)N/ � �1 uV� , r D r\. 410 V"
Drywall Nailing Qv s U 1 , r 1 v lJ C'
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
M (:HANICA
Rough -In
Gas Line
Smoke Dampers
PART FAIL
ELECTRICAL
Service
•
Rough -In
Slolt
Low �
Low Voltage /-?/
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay -t City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: / IA Unable to inspect – no access
Fire Supply Line
ADA /
Approach/Sidewalk Date/ a Inspector ! �� •
Other:
Final DO NOT REMOVE this inspection record fr the jo . = Ito.
PASS PART FAIL I 0
BUP - Building Permit ELC - Electrical Permit
4 Inspection Description Date Passed By - V Inspection Description Date Passed By
Footing /Setback Underground cover _
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof
Roof ailing - --
l ,4 Inspection Description Date Passed By
Fire
— – Low voltage
Tilt -up panel _ Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Inspection Description Date Passed By
Drywall nailing Post/beam mechanical
Suspended ceiling
Gas line
Engineered soils ` Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final
Structural observation Smoke detector
Fireproofing Lab Final _ Mechanical final ���i
Final inspection —
PLM - Plumbing Permit
BUP — Fire Protection System Permit Inspection Description Date Passed By
Inspection Description Date Passed By Plumbing underslab
Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final
Rain drain
_ Storm drain
_ Water service _
SIT - Site Permit Sanitary sewer
'/ Inspection Description Date Passed By Culvert/catch basin I I
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines _
Sprinkler underfloor /slab
_ Catch basin/Manhole SWR - Sewer Permit
Engineered soils Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
is \dsts \forms \InspRecordBUP.doc 04/17/01
CITY TIGARD MECHANICAL PERMIT
4 ,,4 y DEVELOPMENT SERVICES D ATE RMII #: 9/4/03 -00541
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S135D6 05600
SITE ADDRESS: 11400 SW 95TH AVE
SUBDIVISION: MILLER ZONING: R -4.5
BLOCK: LOT: 009 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
OIL 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install oil boiler.
Owner: FEES
WINTER, STEVE Description Date Amount
11400 SW 95TH AVE
PORTLAND, OR 97223 [MECH] Permit Fee 9/4/03 $72.50
[TAX] 8% StateTax 9/4/03 $5.80
Phone: 503 - 612 - 4553 Total $78.30
Contractor:
FIRST CALL HEATING & COOLING
1650 NE LOMBARD
PORTLAND, OR 97211 -4798 REQUIRED INSPECTIONS
Phone: 503 - 247 - 2054 Heating Unt Insp
Final Inspection
Reg #: LIC 102030
9 n
C.4
This permit is issued subject to the regulations contained in the 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 180 days of issuance, or if work is suspended 4
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon - _
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By: t, f, . I Permittee Signature:
Call (503) 639 -• 175 by 7:00 P.M. for inspections needed the next business day