Permit CIT OF TIGARD MECHANICAL PERMIT
A-4N DEVELOPMENT SERVICES PERMIT #: MEC2000 -00414
-' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/17/00
PARCEL: 2S 103AC -03300
SITE ADDRESS: 12525 SW 112TH AVE
SUBDIVISION: MCMICHAEL HEIGHTS ZONING: R -4.5
BLOCK: LOT: 005 JURISDICTION: TIG
CLASS OF WORK: OTR 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Install gas furnace and associated gas piping.
Owner: FEES
JOHNSON, MICHAEL B + VALERIE L Type By Date Amount Receipt
12525 SW 112TH AVE PRMT CTR 10/17/00 $72.50 2720000000
TIGARD, OR 97223 5PCT CTR 10/17/00 $5.80 2720000000
Total $78.30
Phone:
Contractor:
FIRST CALL HEATING & COOLING
1650 NE LOMBARD
PORTLAND, OR 97211 -4798 REQUIRED INSPECTIONS
Gas Line Insp
Phone: -3311 Heating Unt Insp
Reg #: LIC 102030 Final Inspection
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 onto foifow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0e 1 -0010 through oAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calli • (503)246 -9189.
h /t:t14 Iss • By: 1 `�E /��;.,� Permittee Signature: /
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busine day
RECEIVED
-
OCT 1ozo00
411i Mechanical Permit Application
City Datereceived: Permit no_;
' -j City o f Tigard Project/appl.no.: Expire date-.
C&y /Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: B I Receipt no.:
Phone: ($03) 639 -4171
Pax: (503) 598 -1960 Case file no -: Payment type:
Land use approval: Building permit no.:
TYPE OF PEIRRII I
L7t1 & 2 family dwelling or accessory 0 Commercial/industrial Cl Multi- family U Tenant improvement
U New construction Cl Addition/alteration/replacement ❑ Other.
JOB SI1 L' 111O11MATTON ('Ot1\IERCIAL VALUATION SCHEDULE
. Job address: 2 7 e - \ \ 2_ h 1 Indicate equipment quanddes in boxes below. Indicate the dollar
Bld:. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax m . , . lot/account no.: profit Value $ •
Lot; Block: Subdivision: *See checklist for important application information and
Pro• .:.. • jurisdiction's fee schedule for residential permit fee.
ci /county: \ , «)- i ZIP: p( a 3 1 & 21,11%11;X lltt'ELLTNC FE• R\IIT FEE SCI I I?1)Cn.F
Description and loca `:onof wor on prem , 6 =z,> ,fice•7 AND CO11MERICA L/ IN1 )t'SIItI ;Ql J1Pi19ENTSCHLDuE
.> c . /1 - , 11 Fee(e r.) Total
Est. date of corn . letion/ins . tion; Description Qty. Res. only Res. only
Tenant improvement or change of use: Ill A
Is eeisdng space heated or conditioned? O Yes O No ir' condling ante CFM
Is existing space insulated? O Yes O No Air con • • On Ds (bite 'lane abed)
P teranon o - : . n : •y system ME
\IFCHANICAL CONTRACTOR : .ier compressors .
l - - C ,c ■\ l t,k c . e, �� C [; v 1 ■ IA.,-; State boiler iii' . permit
Business name: ∎ 1
._
. Address: f 4 . r [iF Tons • BTU/H
IIMMINNMEIMIIIII State* P ZIP :61 i z 11 Heat .u. , . (a to an req r^. INE
Install/replace furnac ' •tuner loo,om1 :TU
Phone: z �('1 - ?05 1 Fax:223�- 1 ' E-mail: Including ductwork/vent Bner O Yes o No ) -' l •-f . co
CCB no -: \l•� ' 7 _ ,.3 es rep ac a ovate eaters suspended. ■ �-
City/metro lic- no.: ---t O g wall, or floor mounted
Name (please print): L.ci(‘) ' - 5 'eat . anceo er . . ce M ��
CONT:ACI PERSON .z. ■ �-
Absorption uni vnits BTU/H
Name Chillers HP ME
Address: Co. , .ressors _. HP �
Cl State: ZIP: Envuvmeu : absurd , yen : n oe: II
Appliance vent .
Phone: Fax: E - mail: a er ■ oat
_r:,:_ .. - . - T . _ s - w .,_ - _ . _.. - - _.__, -- ----- — .. , , Type . • azmat II
hood fire suppression system
Name: TY\ \ .. r L V CL\ .e r l �0 \'\ l'\ Sc' 1 l Exhaust fan wi th single duct (bath fans) - •
Mailing address: p 5 ,i L. - \ -- IA iA.4-( . . system apart . •ntheattngor M
vii State: D ZIP: a 1 Z2 Lye prpmg . , . h up to 4 outlets
City; T \ Type: 1.PGxc Oil I.1 . o
Phone :5 111=fil 111,; Fax: E - mail: Fuel pi, n: • , .dtdon - over ou PM ��
1' tiCa \ELR : of : ems required IM
Number r outlets of outlets
Name: Other 1171*. , -, • nee or equipment! ■
Address: Decorativefireplace
City: State: ZIP: Insert- J . 1.1.
Phone: ErM1110111 &ul: Woodstov pe etstove — ��
A..licant's signs.. , e--72 /t0z,. «--(„G' Date: /O -- ) Other —
Name . -, t): O (weer 5 7 s I
- 'Not art S � accept t card, please call Jurisdiction for Notice: This permit hcation Permit foe $ ' z .50
O �fiaa OMastetCarC aPp Minimum fee $
cwt card amber / / expires if a permit is not obtained Plan review (at , %) $
Expires within 180 days after it has been Stare surcharge. (8%) .... $ 5 RCS
ame cumoIda o: shown oa S accepted to complete. TOTAL $ �c.)
— cardholder slputee AJnv`s 423-4617 (6106/cOM)
7 nnri T1.1RRTT To R'T'1 ra7rbooene vcr.r re•an nnnTinn,nT
• CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 - Business Line: 639 -4171
UP 1
Date Requested /1» Z 3 AM PM BLD
i
Location I ?- J Z ' S w //Z of 4, t Suite MEC 74,44/ —moo y /
Contact Person Ph 7 Z V 7 Zect PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final �� V 1b LTJl7 S
PASS PART FAIL
PLUMBING o 0 I Cs5N1:, , �1 t ✓L
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CHA
Beam
Rough In
Gas Line
Smoke Dampers
gE S 1 D•ART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA 4
Approach /Sidewalk Date )(� � 23 Inspector fl Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspectio record from the job site.
CIT ' OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 - Business Line: 639 -4171 MST
Date Requested /0 o),j AM PM BLD
Location /2..c LS' $ k/ /1 Suite MEC "--14./ -
Contact Person Ph c � &lift PLM
.,
Contractor P L ` g r< 77 WR
BUILDING Tenant/Owner p /�dco."/ � e c Li n dc. s-P4�3 ELC 2a -O' 5
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam 3
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing 1L a- (.e( yf)C4
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling i;A/#9- 40
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
, MECHANICAZ\
t & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS AMMO FAIL
rvice
Rough In
UG /Slab
Low Voltage
Fire Alarm
Fi
SS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ I Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk
Other D ate /O T 7D Inspector . Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUP -,Building Permit • ELC - Electrical Permit
4 Inspection Description Date Passed By Al 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 /0 -.43- et) d0
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing Ai Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing 4 Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line Z 3 OC
Engineered soils � - �'�
Welding Lab Final Mechanical rough -in
Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofing Lab Final Mechanical final /
Structural observation
Final inspection
PLM - Plumbing Permit
Inspection Description Date Passed By
BUP — Fire Protection System Permit Plumbing underslab
J Inspection Description Date Passed By 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
J Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP PLM, SWR, ELC ELR, MEC, SIT PERMITS
. , .
` CITY OF TIGARD MECHANIC/.LPER1 MIT
a f DEVELOPMENT SERVICES PERMIT #: MEC2000 -00414
'" :�1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/17/00
PARCEL: 2S 103AC -03300
SITE ADDRESS: 12525 SW 112TH AVE
SUBDIVISION: MCMICHAEL HEIGHTS ZONING: R -4.5
BLOCK: LOT: 005 JURISDICTION: TIG
CLASS OF WORK: OTR 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install gas furnace and associated gas piping.
Owner: FEES
JOHNSON, MICHAEL B + VALERIE L Type By Date Amount Receipt
12525 SW 112TH AVE PRMT CTR 10/17/00 $72.50 2720000000
TIGARD, OR 97223 5PCT CTR 10/17/00 $5.80 2720000000
Total $78.30
Phone:
Contractor:
FIRST CALL HEATING & COOLING
1650 NE LOMBARD
PORTLAND, OR 97211 -4798 REQUIRED INSPECTIONS
Gas Line Insp
Phone: -3311 Heating Unt Insp
Reg #: LIC 102030 Final Inspection
'X
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 1
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law qz
requires onto foHovules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR C
952 -0t 1 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by Z
calli (503)246 -9189.
,. ' ) lo
Iss • By: , ,dl Permittee Signature: hC.41/t. Nk
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busine day