Permit CITY OF T MECHANICAL
A N DEVELOPMENT SERVICES
PERMIT
'Vr; ql PERMIT # ° MEC96 -0379
13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171 DATE ISSUED: 11 / 04 / 96
PARCEL: 25110CC -12600
SITE ADDRESS...: 16005 SW QUEEN VICTORIA PL
SUBDIVISION ZONING:
BLOCK • LOT
CLASS OF WORK..:ALT FLOOR FURN ° 0 EVAP COOLERS: 0
TYPE OF USE -SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP.•:A1 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP : 0 DOMES. INCIN: 0
3 -15 HP : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS?..: 30 -50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP ° 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER. UNITS.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =100K BTU: 0 ) 10000 cfm: 0
Remarks: altering furnace vents /ducts
Owner: -- FEES
ELIZABETH ROGERS type amount by date recpt
16005 SW QUEEN VICTORIA PL PRMT $ 25.00 TAT 11/04/96 KING CITY
5PCT $ 1.25 TAT 11/04/96 KI NG CITY
KING CITY OR 97224
Phone #:
Contractor:
SOUTHWEST SHEET METAL
10415 SW 72ND
PORTLAND OR 97223
Phone #: 503 -246 -6284 $ 26.25 TOTAL
Reg #° .: 45089
REQUIRED INSPECTIONS
This per.it is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection
applicable laws. All work will be done in accordance with Final I n s pe ct i o n
approved plans. This per.it will expire if work is not started • Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signatu
Issued By:
C 1 for inspection — 639 -4175
-. - IOU- 04 -'96 MON 21:40 ID: FAX NO: 11443 P02
'• • ". f ' NW--02 -' 96 SAT 03:30 ID _ FAX N0! 11441 P02 '1' '
Plan Check*
CITY OF TIGARD Mechanical Permit Application Read By. {
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Data to P.E
(503) 639 -4171, x304 Date to DST
} Print or Type Permit # rECG� o
Called Incomplete or illegible applications will not be accepted 1
aS / /UCL ' /c2t0C
�° or MY Description
I•") 0'14'11'177Z/ . Table to Mechanical Code 0 Prue; Aur
•0- :' 10.00
Jab )t. oo .5 t eg..) 9" A) •enni se
Address' 1- o -
yysft VA 0) 5upplernentat Permit 3.00
kt C.1 _04- e ncU L I 11111 mein, (a Mime Of Ns 1.) Furnace to 100.000 BTU MN 00
0016 rd; CiTYC Q,eA- S Ind. ducts a vents
aimsManoae r 2.) Furnace 100,000 ; * 7. I III
S, 4ML � U G Mel. ducts & vento
City /Slats p I Phone 3.) Floor Furnace 6.00
cod. vent
Name (or name ei busk,...) 4.) Suspended heater, wail neater 6,04 • .
S L I Ad, 0 ? .......,, or floor mounted heater
Occupant as AcitirEss e.) vent not rncl, in 3.00 1
applianceErrnit
GItRrbtite zip 1 Phone 6.) Boiler or camp, haat pump, air rand. 6.00
to 3 HP; absorp unit to 1001C BTU
N emo 7.) Boiler =ICI. r or come. heat pump. sir 11,00
■ +1" 1-wC�S T S ew*" the 44 8.) Boile
Contractor ' area><ro r am or camp. heat pimp, iire cared. 16.00 Ili
014 1 S SO - 1 a NO 15 -30 HP; ab80 ■ unit .5-1 mil t3TU
Anson mPy or S; , zi Phone i 9.) Boller or comp, heat pump. eir cond. 22.50
Current licen563 T CO' � O y7 a ti HP• elnorp unit 1 -1,75 mil BTU
owe, t I. sent. Beery ad MCP• Dale 10.) Bener or comp. gat Pump, air cond. 37,50
> 00 }1P; ab orp unit 1.75 mll lj•TU
COT B,.dneas Tax of Metro s exv. PA* 11.) Air handling unit SO 4.50
10,006 CFM
Architect '"'° 12.) Air handling Unit 730 i
10. GTNI +
Of ,,, �,.a ..-•• ��� 13.) Non n portable 11111 4.50
eve • • rate molar
Z Friona 14.) Vent fen opnnectCd 3,00 1
Engineer to a single duct
Desctma wAtk New 0 Addition 0 Aiters40ttjk- Repair 0 IS.) Ventilation system not III 4.50
to be done Re9idP.ntim' N orpieeldenfill O Included in apP (e� permit
Description Desrption of knock 16.) I4I Qd monied by
Mechanical exhaust 4
17) Domestic incinerators 7
18.) Commercial or mama, 30,90
exietIng �S. 1 - type incinerator
buildlntj or pnb>yority 1
19. Clothes dryers, eta 4.50
Proposed use 20) Other units • 4.50
Wilding or property � L 1
21) piping one to four outlets 2
Type of fuel - as 0 newel gas LPG O eleztrie O ) C198 P P g
•
More than 4 - et ou et f;87eJ) • •50
1 hCrebY, acknowledge that i have read [1119 apD�Ce0ot1. mat the 22) D
MfomIetlon given is ConecS, Mot I am the owner or authorized agent of CITY. SUB • TAL :: `a' . :'
the owner, that plans submitted are in compliance wet Oregon State ,,v -r . �•
laws. SUBTOTAL f' : .%.':;,i.,` ji t
5Ipr+ataue Wit DBte ,.: : cr.�,;::4 . i6)",......_ X /kV VA SURCHARGE • ' 4 -''ti l '''
PLAN REVIEW 25% OF SUBTOTAL :14 ' °`
Contact Pelson name EvP�.a'.v� �G / �� : ,. .
r
E ` r e 4 - 01317000 , TOTAL . . .. ..: . J . S
. stimecdipmt.doc 'Minimum Permit fee IS $25 t 5% surctiatge
ev 7186
'r
a
RECE I\IED
COMM UNk:. , vetie
. CING" CITE -- STRUCTURA,L_CHANGE_REQUEST
Member / ;2. d z Date 7 - / 9 - 2;
� �a •�_ -- /, ,o-L
Address O d � • � � - � - D- � - - !' �x.� Phone
TYPE OF CHANGE
(Patio Cover, Room, Fence,.etc.)
PLAN: DIMENSIONAL AND MATERIAL DETAILS
I.
Note:
1) Adjacent property owners will be informed of the requested change.
2) If there is an objection, the objection, but not the name of the objector, will
be given to the member asking for the change.
3) The Board of Directors of the Civic Association will review the plans and property •
for approval or disapproval and compliance with the stated restrictions.
4) A building permit must be obtained from the city for all improvements costing over
$500.00
Date Notified KCCA Board of Directors
President
Date to be Completed 9nnroved �. Vice President
Final Inspection Disal • =d Reasons)
eittiA --fgfe4vie.na-04.&
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
D ate Requested /0 /a AM BLD
Location j (20 0 ,5 altao.) 4 JtL ) Suite P �' q6 -(- 3
Contact Person Ph ( 5 2 g° 7 2 /93 PLM
Contractor Ph SWR
BUILDING Tenan ,1•• yy £ ,c_PJ,U ,
ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: , SGN
Slab 6 44 2 SIT
Post & Beam �
Ext Sheath /Shear // 9c 1 e.9.A
'
Int Sheath /Shear
Framing �!� _ / AN// 1 I �1L.A i4
Insulation
Drywall Nailing ,� kQ J r r kp ay-a
Firewall
Fire Sprinkler
Fire Alarm '
Susp'd Ceiling N}- Gc Cam \ V - �� -�VVV 0
Roof ��
Misc: if . am" . L _ . �L
Final
PASS PART FAIL 4- n- UP e S , ' LC- ‘D A-- G
PLUMBING e
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PAS - PART A , ,
MO V/
• � T Beam nt
Rough In
Gas Line
Smoke Dampe
a h r PART FAIL
CTRICAL
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
Approach /Sidewalk �t, G Ext
- 3
Other
Date (✓ ` Inspector " L.Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
G BUP
Date Requested 1 b -' I ''� I AM PM BL
Location / CP CO 5 Q FYI (Ju rr 4 f ) Suite — ® C 7(0" 6°3 77
Contact Person �. 1 %.- 1 .O-�+tv Ve--C) G �S Ph PLM
Contractor J Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: �, l u r Ce U I
Foundation FPS
Ftg Drain
-- -
Crawl Drain ik pect: Not Requesthd At SGN
Slab Found During Research - SIT
Post &Beam 1 P 'Nn Insnectinn(s) In File :,
Ext Sheath /Sh � ar
Int Sheath /S e
Framing
p
Insulation / / / p ,
Drywall Nailin• .6.i. At A, LJ
Firewall a- + r vv
Fire Sprinkler A C./I"-
Fire Alarm , ^ b
Susp'd Ceiling
/�/
Roof
Misc: . -
Final L n ( n n c �r- Q___ Qi..5
PASS PART FAIL V e � � "
PLUMBING yvv6.4 i`_ C'Y L1 _ A -& /4 (4 * 4 6 - 1/ \
Post & Beam \
Under Slab U T vl,S.- 1\-1-tiJr t' Cc LQ °----(j` 7
Top Out � /l
Water Service Cr w Z v "L w\ 1 LQ •
Sanitary Sewer
Rain Drains
Final
PASS • RT FAIL
Post & Beam
(�q- 4r/ 1 K �) (c : ��-
Rough In
Gas Line (CYYZ)
d
.�;(.
PASS PART FAIL ��,'A w)� ?-L/ A
ELECTRICAL 3q — 1 � S
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE rr
Backfill /Grading � ,1
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 Q� (.1°) n
Approach /Sidewalk Date ) v I nsp ector V / � c)
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.