Permit 4,, CITY O TIGARD. MECHANICAL
._, • .
DEVELOPMENT SERVICES PERMIT
11 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # - MEC98 -0568
DATE ISSUED: 12/21/98
PARCEL: 1S125DD -09900
SITE ADDRESS...: 09600 SW VENTURA CT
SUBDIVISION ° WASHINGTON SQUARE ESTATES NO.3 ZONING: R -4.5
BLOCK LOT °107 JURISDICTION: TIG
CLASS OF WORK.. :ALT FLOOR FURN ° 0 EVAP COOLERS: 0
TYPE OF USE °SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP.. :R3 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..: 1
GAS PRESSURE...: 50+ HP ° 0 CLO DRYERS.. : 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 1
FURN < 1O0K BTU: 0 (= 10000 cfm: 0 GAS OUTLETS.: 1
FURN )=1O0K BTU: 0 > 10000 cfm: 0
Remarks : Install gas insert, gas logs and gas piping.
Owner: FEES
MICHAEL J WILBERDING type amount by date recpt
9600 SW VENTURA CT PRMT $ 26.O5 GEO 1/21/98 98- 311663
TIGARD OR 97 223 5PCT $ 1.25 BED .12/21/98 98- 311663
Phone #: 245 -9768
Contractor:
G P & W SYSTEMS INC
732 MARBLE RD
$ 27.30 TOTAL
WASHOUGAL WA 98671 -9601
Phone #: 360- 835 -3516
Reg #..: 001081
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952- 001 -0010 through OAR 952- 001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
, // Xjr. .../7144:6c7
Issue By: 4.:L "% Permittee Signature:
+++++++,+++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
•
Plan'Check�# '
CITY f TIGARD Mechanical ;Permit A ' Rec'd By . '
13125 gW HALL BLVD. Commercial and Residential Date Recd '
TIGARD,'OR 97223 Date to °P.E'.
Date to DST
(503) 639- 4171`, x3 �V , Perrriit4 Ate QX -0564$
Print or'Type . . cooe
Incomplete or i will not be accepted • ,
Name of Development/Project ' Description • '
Table 1A Mechanical Code " QTY PRICE ; AMT
Job Street Address Suite# A) Permit Fee 4- -0- 10.00
Address 1•f6oc, S2 1 Ui *JVZL (-.
Bldg# City /State Zip 1.) Furnace to 100,000 8TU 6.00
e re) g 72.2 including duds & vents
Name (or name of business) ✓ 2.) , Furnace 100,000 BTU+ 7.50
Owner LL) t ' ,� �� including duds,& vents
Mailing Address _ - J I 3.) Floor Furnace 6.00
including vent '
City/State Zip ,, Phone 4.) Suspended' heater., wall heater ' 6,00
I LYS - 9768 or floor mounted 'heater ' , ' •
Name (or name of business) "5'!) Vent not Included' in appliance, permit • 3.00 • '
Occupant Mailing Address 6.) Boiler or Comp, heat pump, air and :, i ,5.0,0
to 3 HP; absorb unit to 100K BUT"' .
City/Slate Zip I Phone. ' • 7.) Boiler or comp, heat pump air cortd . 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor `Name ' 8.) Boiler or comp, heat pump, aircond. 15.00
6 pr tA Sus rnS 15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit Mailing Address , 9.) Boiler or comp, heat pump, air cond. 22.50• '
issuance, a copy -732. 1140A.17 62 (244. 30-50 HP; absorb unit 1- 1.75mi1 BTU" •
of,all licenses City /State ` p a � Zip Phone - 10.) Boiler or comp, heat pump, air cond: . ' 37.50
are required if LU[� �xP i/ 3$ - 3S /(0 • 50 HP; absorb unit 1.75 mil BTU" .
expired in COT Oregon,Const. C . Board Lic.# ' Exp. Date. 11'.) Air handling unit t� 1(1,000 CFM,. 4.50
database /6fr/ `760 ' 1 ', .
Architect N ame . 13.) Non- portable evaporate cooler ' • ` 4 :50 '
Cw 3595 Slnh
or Mailing Address 14.) Vent fan connected to a ' 3.00'
Engineer City /State Zip Phone 15.) Ventilation system not included in 4.50 .
appliance permit „
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical,exhaust 4,50 .
to be done Residential 0 Non - residential O
Additional Description of work: - 17.) Domestic incinerators 7.50'
ins-hr e gas umeet al -Fi ola4z yd
c
iii 4 - 4, de 18.)' Commercial orindustrial type 30:00
Incinerator
Existing use of •� / ! te e ,* �efR O/t%L4f , 19.) Repair units 4.50
building orproperty C'
20.). �Aleeehstove q 4�.0 - 4.50 u �� tet.
Proposed use of 21.) Clothes dryer, etc. „ ' • , 4.50
building or property '
22.)' Other units' 9 �'� ' , „ 4.50
Type of fuel - oil 0 natural gasX LPG 0 electric'0 , 23.) Gas piping rone to four outlets. ' , o , , ' 2.00 2 ,r--
I hereby acknowledge that I have read this application, that '241) More than 4 -per outlets (each): ' '.50
information given is correct, that I am the owner or authorized agent of ,
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL '
laws.
Signatu Owner /Agent Date 'SUBTOTAL ' '
#' I 4P016' 5��1
/ " /A /Xr 5% SURCHARGE i ////
f. .
Con �e rson Name P ne PLAN REVIEW • 25% OF SUBTOTAL
( 740) 0.1c
X2'1,_ ke n a i J -3r/6 TOTAL
r.\rnech t.doc (rev 9 •Minimum perrnitfee'is S25'+ 5 %surcharge ►�
. , "Residential A/C requires site planIshowing placement of unit. !r
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
733 Date Requested /.Z 'l AM PM BLD
Location "00 � �/� ... I / Suite
Contact Person �C,�r,Ul,�/l _ Ph ° `"7 ` ' (76 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation d u FPS
Ftg Drain
Inspection Notes: /r +�'/ Z' SGN
Crawl Drain Ins
Slab P "` - i �� , SIT
Post & Beam � 'Lest /S /� /�,/ "� 5 / /
Ext Sheath /Shear �v c.� x�v'r /
Int Sheath /Shear
Framing
Drywall on
Drywall Nailing p&aat
Firewall
Fire Sprinkler
Fire Alarm
Ceiling (� ) taS = Doti
Roof / /�,iUT�S - 2 -
Misc: ?9
Final � _
PASS PART FAIL !.� ' 4: 'o `� ki /7 O AS ? LPG' ( 5 1 P�Ae IT i' '`-e--�
PLUMBING fdr,q7-- G�i4crC,t�
Post & Beam )
Under Slab / (3422, , z /I i iii •�/�� l iLB ��ry �(J i�J
Top Out �// __ /�
Water Service r�L Z` / / �P �� /
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CHANICA
Post & Beam
Rough In
w !
as Line r /
smoke Dampers
Final
PART FAIL
ECTRICAL
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 � Z3-- J �tl Ins ector • • Ext
Other Date p
Final
PASS . PART FAIL DO NOT REMOVE this inspection record from the job site.