Permit I E � HANICAL PERMIT
, ci f ( 7 , :FAY C ITY OF IGAR
a COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00549
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/22/2007
PARCEL: 2S112DD -01100
SITE ADDRESS: •15700 SW UPPER BOONES FERRY RD ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
PROJECT: HOLIDAY INN EXPRESS
Project Description: Install heat pumps and ductless split systems for corridors, fitness room, lobby and pantry. Project Val
$39,000. 4/8/08 ADDED (1) gas outlet.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 VENTS W/O APPL: VENT SYSTEMS:
STORIES: 3 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 2 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 3
> 10000 cfm: GAS OUTLETS: 3
Owner: FEES
BHGAH TIGARD, LLC Description Date Amount
PO BOX 1670
WILSONVILLE, OR 97070 [MECH] Permit Fee 10/22/20( $623.00
[MECPLN] Plan Rev 10/22/20( $155.75
[TAX] 8% State Surcha 10/22/20( $49.84
Phone: 503- 783 -5222 CITY OF TIGARD MEIN 4/8/2008 $5.40
[TAX] 12% State Surch 4/8/2008 $0.65
Contractor: Total $834.64
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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 or 1.800.332.2344.
0 p ,
Issued By: /� /� ! ` - ittee Signature: • ��`
Call 503.639.4175 by 7:00 a.m. for inspecti • • tha • usiness day.
This permit card shall be kept in a conspicuous place on t r e job e until completion of the project.
Approved plans are required on the job site -t th ime of each inspection.
1:57c1:!, (23 0 imal - ::3:2)1 r 44 /3/4/ 7-SA
•
Meadeal Permit Application FOR OFFICE USE ONLY
AY Permit No.:
13125 SW Hall Blvd Tard felet6r7.....40:5
Received
City of Tigard Date/By 9 /7 .07
., OR 97223 RE -
is Other Permit: _
Phone: 503 639.4171 Fax: 503.598.1960 • - 1 rAii:i4',,14111 ' . lisbi''" i ..1% Mot' I I
1 1 1 ' ' -.—
Inspection Line: 503.639.4175 •.„4,; - 1 . ... - .:1.• ' eady/By/0 AA lip■ la See Page 2 for
:
Internet: www.ci.tigard.or.us Notified/Methad
us / 9 el (. /a Supplemental Informatl ki
SEP_11 2007 ,,,„_ .f.-.A ...- A AL 1'
COl■ . MERCIA L '' .. SCHEDULE - , 5E C '
' : *:" • :.: : ' .... . • •. TYPE OF I -. -
• - Mechanical permit fees* are based on the value of the work
0 New construction Lit Add i ti onidtcrintic.itidi t-- performed. Indicate the value (rounded to the nearest dollar) of all
_3 ULA) DIVISION
0 Demolition 0 Other: — L mechanical materials, equipment, labor, overhead, and profit.
• I f 3,, co
i. ;. ::•: .::: •1:,•:: • :„ .
CATEGORY oF coNsplu .- o
ctioN . -
Value. $
•-,-. !REsippriApiNwpmE.,. / SYSTEMS FEES
0 1- and 2-family dwelling Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family Master builder 0 Other: Description I Qty. I Ea. I Total
•
• ' --''' ''-'• ..- ' JOB INFORMATION AND LOCATION • Heating/cooling
. . .. , . .
Air conditioning or heat pump
Job site address: is- a 1) "7 ()or)-e_S rer , Pol (requires site plan showing placement) 14.00
City/State/ZIP: Furnace 100,000 BTU (ducts/vents) 14 00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg/apt. no.: Project name: il
//i/ 6950 Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: 1 Lot no.:
Other. 10.00
Tax map/parcel no.: Other fuel appliances
i;,:it -PFsPPIPTiori c),F. WORK ' :'• ' .- ' . ' Water heater 10.00
''' ' '
•
dr Gas fireplace 10.00
'O b.-e p u el- -) p 5 c Flue vent for water heater or gas
fireplace 10.00
S 5 ; , , M S' me v 6)- ..- d'e
_. . , Log lighter (gas) 10 00
r
.... c7_,&vS S r DO 61;) ... 4 ,-- )artfri Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
-
tl : p .??'1%T' Pl ,,1 ,, ', ., .. 0 TFNOT ,:;::,;,,,::! s, -
Other 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: - equipment 10 00
City/State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) Fax. ( ) toilet compartments, utility moms) 6.80
•' I: y ilAFFPCANT .,
ON
• ' : ' : . 0 'CONTACT PERSON ' :, ,,
. „ . ., , .. . . .. . .„ . , . Attic/crawlspace fans 10.00
Other 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Water heater
Phone: ( ) . Fax: : ( )
Fireplace
E-mail: Range
1!`•',4511i);;;Jiiiil:F:iii'!:i t 001 , j'Aii;•r '' ! Barbecue„
, 2, 6 Clothes (flyer (gas)
Business name: g aili li_ecd 1-13 Other
Address: p j.,p 6 ' illtVittl':':: ,. . OF§1}::-.-‘';
City/State/ZIP: a i,-A / IJIR 9 zo/
3 Subtotal
Minimum permit fee' (S72.50)
Phone: (503) Z.Lato .--t 2./,/ 9 I Fax: (5P5) 2 1 - 91717/ Plan review (25% of permit fee)
A il
CCB lic.: / L LIU f c
ie ■12 State surcharge (8% of permit fee)
PlikilWrf TOTAL PERMIT FEEred
,64?
This permit application expires ir a permit Is not obt awl within ISO
Authorized signature: ,A Of/ a j i • i _ f days after It has been accepted as complete.
r Print name:
--i-- I - -...--• - eje AlliViallair — - _g_ _. ' Fee methodology set by 'Fri-County Building Industry Service Board
- -
I ''' ---
...-
4.111 41.17 rill 02 WI:11)
Ltilmitlinecumis`1■11:C-I'LloliiiApp doe 12/03
i
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: IVMEC2007 -00549
13125 SW Hall Blvd., Tigard, OR 97223 , DATE ISSUED: 10122 2001
Phone: (503) 639 -4171 j�l
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' 1!. i 1
INSPECTION WORKSHEET FOR DATE: 6/9/2008 TIME: 7:01AM PAGE: 32
SITE ADDRESS: 15700 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOLIDAY INN EXPRESS
DESCRIPTION: Install heat um s and ductless s lit stems for corridors, fitness e M, lobby and pantry. Project
Value: . 1, l . 4/8/08 gas out et.
OWNER: BHGAH TIGARD, LLC, PHONE #: 503 - 783 -5222
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503
Inspection Request Scheduled For: Date: 6/9 /2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 071065-01 503-209-7181 N
Corrections /Comments /Instructions:
CY ( 1?((--k.A.-- ! X s t <
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9
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[SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 i/� '�j � (06/d Ins ector: 1, /� �L ( / Date: r Phone #: (503) 2'�
P � ) 718 -
Jun 09 2008 2:03PM ROTH HEATING 5032632513 p.1
Fax TransmittaI
ROTH
HEATING & COOLING
TO: Rick Bolen FROM: Jesse Manselle
COMPANY: City of Tigard (503) 793 -5573
FAX NUMBER: (503) 624 -3681 PAGES (including cover): 1
PHONE: (503) 639 -4171 DATE: 6/9/08 TIME: 2:15
RE:
Holiday Inn Express CC:
® For Approval ❑ For Review ❑ Please Comment ❑ Please Reply
❑ As Requested ❑ For Your Use El
REMARKS:
Rick,
It has been confirmed that all of the fire smoke dampers at the Holiday Inn Express are
functioning. Please call me if you have any other questions.
Thank You,
Jesse Mansellle
Cell (503) 793 -5573
Office (503) 266 -1249
Roth Heating & Cooling , PO Box 1265, Canby, OR 97013, Phone: 503.266.1249, Fax: 503.266.3478
CITY OF TIGARD
BUILDING DIVISION I PERMIT #: MEC2007.00549
13125 SW Hall Blvd., Tigard, OR 97223 �✓� ATE ISSUED: 10/22/2.007
Phone: (503) 639 -4171 / Inspection Requests (24 Hrs.): (503) 639 -4175 s� tI..
INSPECTION WORKSHEET FOR DATE: 1012912Q07 TIME: :0-} M PAGE: 35
SITE ADDRESS: 15700 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: 1101_IDAY INN EXPRESS
DESCRIPTION: Install heal pumps and ductless split. systems for corridors, fitness room, lobby{ and pantry. Project
Value: $39,000
OWNER: BHGAH TIGARD, LLC, PHONE #: 503
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503-26 &1249
Ins Inspection Request Scheduled For: Date: 10/29/2007 Pour Time:
P 4
300 #
Code # Inspection Description Confirm # Contact # Me --.4
615 Mechanical rough -in 058513-01 503 -849 -2.171 i ll°
Corrections /Comments / Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \4‘CR----/ hh , (y
Date: l U v` ( -) Phone #: (503) 718- 2—Y.2-11
CITY Of TIGARD • ,,
BUILDING DIVISION PERMIT #: Mt�G2007 00549 13125 SW Hall Blvd., Tigard, OR 97223 RATE ISSUED: 10/22/2007
Phone: (503) 639 -4171 7
Inspection Requests (24 Hrs.): (503) 639 -4175 s ��
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7 :00AM PAGE: 79
SITE ADDRESS: 15700 SW UPPER BOONES FERRY RD s. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOLIDAY INN EXPRESS
DESCRIPTION: Install heal pumps and ductless split systems for corridors, fitness room, lobby and pantry. Project
Value: $39,000
OWNER: BHGAH TIGARD, LLC, PHONE #: 503- 783 -5222
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503.266 - 12'19
Inspection Request Scheduled For: Date: 1119/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas Tine 059312 -01 5 503 - 849 -2171 N
Corrections /Comments /Instr ctions ogo •
[ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: n Date: 1/1 ) In Phone #: (503) 718- 171
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00519
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/20t)7
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s 1!
INSPECTION WORKSHEET FOR DATE: 17127/200 TIME: 7:00AM PAGE: 73
SITE ADDRESS: '15700 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOLIDAY INN EXPRESS
DESCRIPTION: Install heel pumps and ductless split systems for corridors, fitness room, lobby and pantry. Project_
Value: $39,000
OWNER: BHGAH TIGARD, LI..C, PHONE #: 503-783 -5222
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 - 266.1249
Inspection Request Scheduled For: Date: 12/27/2007 Pour Time:
Code # Inspection Description Confirm # - • Message
615 Mochanical rough -in 062137 -02 503 -649 -2171 N
M AFT
Corrections /Comments /Instructions:
'--- )1/4tL 1 —/ft) 5 Th7 '.
01
Z I i-)T--mot 4 c •
❑ PASS t; -ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r 1 - '3
Inspector: Date: Phone #: (503) 718
CITY OF TIGARD /,/-
BUILDING DIVISION PERMIT #: ZQ:D7 "9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 I �..
INSPECTION WORKSHEET FOR DATE: IA f(8 TIME: PAGE:
SITE ADDRESS: (S 7GC'J 5 U Pp_ 7LYDltjGS CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOJJ L //LW
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: rtit- PHONE #:
Inspection Request Scheduled For: Date: VS108 Pour Time:
Code # Inspection Description Confirm # Contact # Message
�fs P4o6.1+ 01 o !�
Corrections /Comments /Instructions:
Try (s , c7-- -p- = / TA eFecourRec770.6
&0(( -4brk36- O UrOF 7 )kjl t c-/j (3VlW ( e b
T( tE R `L,(YT C m PLY 101TH- o-IL 7(3,10 koo"D
713.11 F ?c & THE— (ctcr7 t)PC A +�R 7' 0.)(T `
P;2CHt TE cr C C
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c-16:_ _�RA� S Ik) �' TR 4j� utSV
A ) L�3 `t' ACC F rP 5 PcS
❑ PAS - ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i.�
Inspect. Date: 1 3 `27 Phone #: (503) 718 -2431=3
CITY OF TIGARD
BUILDING DIVISION Ate PERMIT #: MEC2007.00549
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2.007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4 /10/2008 TIME: 7:02AIVI PAGE: 18
SITE ADDRESS: 15700 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: l IO1_IDAY INN EXPRESS
S
DESCRIPTION: Inslall heal pumps and ductless split systems for corridors, fitness room, lobby and pantry. Project
Value: $39,000.4 /8!08 ADDED (1) gas outlet.
OWNER: E3HGAH TIGARI), LLC, PHONE #: 503- 783 -5272
CONTRACTOR: ROTH HEATING & COOLING PHONE #: x037.66 1249
Inspection Request Scheduled For: Date: 4/10/2008 Vl Pour Ti
Code # Inspection Description Confirm # Contact # Mes e
695 Misc. inspection 068176 -01 503-1349-2171 Y
Corrections/Comments/Instructions:
6
❑ PASS /PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSES a e
D"
�
y
Inspector: Date: Phone #: (503) 718
CITY OF TIGARD . A
BUILDING DIVISION PERMIT #: MEC2007.00549
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2007
Phone: (503) 639 -4171 il
Inspection Requests (24 Hrs.): (503) 639 -4175 �_' °_
INSPECTION WORKSHEET FOR DATE: 4/15/2008 TIME: 7:02AM PAGE: 27
SITE ADDRESS: 15700 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOLIDAY INN EXPRESS
DESCRIPTION: Install heat pumps and ductless split systems foi r:orrid': s, fitnoss room, lobby and pantry. Rojert
Value: $39,000.4/8/08 ADDED (1) gas outlet,.
OWNER: BHGAFI TIGARD, LLC, PHONE #: 503 - 5222
CONTRACTOR: ROTH HEATING & COOLING PHONE #. 5032M1249
Inspection Request Scheduled For: Date: 4/15/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
625 Duct work 068386-01 503849 -2171 N
Corrections /Comments /Instructions:
« ' ) . j J , 1 - 0(,--)2_C :‘, c -
it\r- .ts--v rk 5.
V1,O: ( 6 - C I . ,
t ) > 1 \J 9-1/. "Nr S \
k,I2A1 teNNA 0.1 "\-- --k'N. j2_ Pjc..\ INce- ,
,....
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ESSED
Inspector: ��` V C__/ Date: t � Phone #: (503) 7183-Alt — `
CITY OF TIGARD
,
BUILDING DIVISION PERMIT #: MEC200? -0049
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10122/2007
Phone: (503) 639 -4171 ittI
Inspection Requests (24 Hrs.): (503) 639 -4175 .�' "'! I..
INSPECTION WORKSHEET FOR DATE: 4/1&2008 TIME: 7:02AM PAGE: 30
SITE ADDRESS: 15700 SW UPPER BOONES FERRY RC) CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOLIDAY INN EXPRESS
DESCRIPTION: Install heat pumps and ductless split systems for corridors, fitness room, lobby and pantry. Project
Value: $39,000.4/8/08 ADDED (1) gas outlet.
OWNER: EiHGAH TIGARD, LI_C, PHONE #: 503- 763 -5222
CONTRACTOR. ROTH HEATING & COOLING PHONE #: 503 - 266-1244;
Inspection Request Scheduled For: Date: 4/15/2008 Pour Time: rt
Code # Inspection Description Confirm # Contact # Me ge
515 Mechanical rough -in 060383.01 503- 848-2171 ? •
Corrections /Comments/ Instructions:
V 6 O I G -Y-e.
t. r C r 5,,2,e_-
C...9
❑ PASS PA PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Nit
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: W(T 4 ( 1 /° r phone #: 503 P � ) 718- 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007.00549
13125 SW Hall Blvd., Tigard, OR 97223 ■ DATE ISSUED: 10/22/2001
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 _..' IL. --
INSPECTION WORKSHEET FOR DATE: 4116/2008 TIME: 7:02AM PAGE: 26
SITE ADDRESS: 15700 SW UPPER BOONES FERRY RC) CLASS OF WORK:
SUBDIVISION: LOT #: (---; TYPE OF USE:
PROJECT NAME: HOLIDAY INN EXPRESS
DESCRIPTION: Install heat pumps. and ductless split E sterns for corridors, fitness room, lobby and pantry. Project
Value: $39,000.4/8/08 ADDED (1) gas outlet.
OWNER: E3HGAH TIGARD, LLC, PHONE #: 5037835222
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503265-1249
st
Inspection Request Scheduled For: Date: 4/15/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mes : ge il,
610 Gas line 068386 -02 503.1349 -2171 Y """"2222 ____ n
Corrections /Comments /Instructions: I V' _
N - \l/k; A
(AEI 3 9
! k.-, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES SESSED
Inspector: VV' Dater /\ S d Phone #: (503) 718- 7-1 ‘ii
CITY OF TIGARD , i_______
:: BUILDING DIVISION PERMIT #: MMEC2007•00549
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2007
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' 11.
INSPECTION WORKSHEET FOR DATE: 6/4/2008 TIME: 7 :01AM PAGE: 28
SITE ADDRESS: 15700 SW UPPER BOONES FERRY RD CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HOLIDAY INN EXPRESS
DESCRIPTION: Install heal pumps and ductless split systems for corridors, fitness room, lobby and pantry. Project
Value: $39,000.4/8/06 ADDED (1) gas outlet.
OWNER: BHGAH TIGARD, LLC, PHONE #: 603- 783 -5222
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503
Inspection Request Scheduled For: Date: 6/4 /2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 070816-01 503 - 209 -7181 N
Corrections /Comments /Instruction : 6■rej Lej
'7 S . i 0
k
/ , t ' Of f , . '
r - N &(4) / r i I e ( VL__-
r
it 91 ....
r 'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: (e/q Phone #: (503) 718- i /