Permit G .-.', ,4,,,...,,,,,,i0,-„,4
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.
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.. IT . ,- F ox � n d 4 p � I��d 6 Hi � ' DEVELOPMENT SER
� ,c•r.;vlIT it. .,.:... n MF-C'�iEi-- �.�f178,4.„,
f I �' >t, 13125'SW'HalI Blvd., Tigard, OR'97223 (503) 639 - 4171 DATE I SSUE D,n„ ' 02/0/?Fr '
• PARCEL; S 1 2DA- -ESE 1 -L 1700 ' .
SITE ADDRESS.... 11105 SW SUNI vER LAKE DR .
.SUBD I. +i ? SI O . - , - , PME=1 RT SU '1i* E?)_(1KE. ' f N I NG ;, R -T ,
BLOCK ..........f, - ..., .... . LOT .....'_ . _ .., .. a 1033 RJRISDICTION I' .
r t,t zula� s
CLASS; ; OF WORK.. a ALT FLOOR FURN. _ . ,. 0 , . . E COOLERS S'y 0, .
TYRE OF USE.... ; SF, ' . ' , UNIT FEE; iT E.F z'.. , !i;! • , VENT . FANS. „ . 0i
OCCUPANCY S P'.. o R; = VENT` W./C, Ai='Pi_. a ID, VENT ' SYSTEMS ‘...' •
STORIES— ... , . . F3OT L'ERS' /.COi HOOD a...' . e . , 21
FUEL 'CVI-- !'_.._:• - --- __ ----- -- 0-3 •r- .1P.., .. ELI DOME'S. INCIN. E,E . -
'. 3 -10 HP... . , .'4 'ID COTMEL. INC I Ni `. E ,
MAX INPUT 2 fil , BTU 1 F- I[='.... 0 ' - REM IR UN'I3 9 'e 0 - '
FIRE ?ar M[--'E.RS ?-, • .. 30.-'50 52 HP„ .. 0, WOOLS TOVES. - „ .
!"AS PRESSURE. - ' i " 5 1_ aari .`CRS f
J I^-� r „ .. . i. ..,J i�, �, f� t r , . . „ 4�. 'OLD :DRYERS. p r __ E "'� . . l _ •
' NO, or I:11 I T S- •-- .- _.___.- .- _- -__._' A I rt HA I -NO ' Uw I TO. OTHER i_iNJ: TS. , ! ";ti
FURN t_ l'OO'. BTU e " , - <', 40000 cfm o 0 131 -15 . OUT i_E��f S„
F; U RN > = 11! R BTU .. 0', , • ; .10000 ' r_ f In; • ! „ , .
' R e ma eas woods`ove ' . ' •
. - - _ _ _
MiAR`)' SCROGGINS - - ty amo kin t • by ce.4e •,_ _
L S''MMERL. ,KE DR PMT 23. B ' EIS; OfV98 ';;E=3.--7,07,942
7. iZi i �bv �It - ;
" ;OARD .O,F2 97L:'2._ 5PC I 1. 2 OS/OS/98 .,, •:•- .=,4_�._,-�a
t
�'tion•e ##. • _
'Contract sir'; - - - --, - -•— _— _ -- — .... ,
T t;. K NN'ECH N1CAI..: ' , - ' ' ' . .
T I MOTHY S WYNNE - -- - - - - - -- -- - ,- - -- - - - -- - -- ; --
1. :1.J, 5 /w CANYON' 1 -.6. 23 TOTAL
' BEAVERTON OR 97005 - •'
Phone # a 62E-4552, .. . . , ''
' R . .# , . . •' o. 01.2' 1 1 : .
_ FRED Li I RED I NSF' E CT I [INS
' Th. # ' oer it. i i isiti -_d sub iect to the regulations contaln?d.1,r :the GELS; Line 1 n's,';, '�'- -
. ,Tlriard Municipal Code, State of Ore.' Specialty C•id -s and all other 6JoouStoIY•r 'Ii'1'rp _ �' -
• 1 1 f _ 1 _
ap,111t_tlblE: !a.�:. All work will be ,dons in accordance. with r 1•n a 1. ITE5,:, e.ct; lCi Cl ..•.___... ._.. -...
appraved plans. This per , wn1 ° K7wrr ii work is not stated -- � _.
Sithi1, 180 Oc'S of issuance, or if 'Work is sUspenc! c for nt'e _._.._._.---- -_—.__ _ _ _ -. `_.. - -.!- _ .._._
Vial `180 slays. ATTENTION: Oregon i,s:a "r�ecluires you to follow ;u# es
adopted. by the Ur °icon Utility Notification 'Ceh er. Moire rules are
.set for 411 in DAR 952101-N10 hroug 1 MR 9°2 -0Z1 CS
G. 'You- H -_ .....- ..— _— _...._- . —..�.� _ • ..te— ____....._.._
- 0b':vn copies of these rubs or direct 'guest i ons t4 „tik:NC by -cal lin �-- - _ °- -- -- _ .
. f 5 5 1 .1e , .. L y . i ("AMA/ . — ` - P C', P M 1 a. tee? , ' 1. a n a t E ^'. rr P B _ I 1 k _ ���'�
- ,;•-r'-rri...r.'...__ ' _. � �. . H f•i -•{- - 4.-ti-,-1-4,- i �•• ',#- � • :.5._F S- •{ - -hi
' „
1• ^ _ " F_"E..�: , _. {__{.:,;- :.E.';7".'h.,i"'i__I a -_t 4.7i- +71 l_..h.{...{...L'. -h-I - E..- h'E'.
C,c' Z1' 639"24 i -5 t ? 7 00 ' ID ... ri '.7'1".4-.;1-.. r , r t 's _P t ey.' 'h 5'a •` - j?
- H' is P° S h { ': { 'y .p. h ; -. �c__ ; -P-17 f . { a,: t { 3' ;�, h ri ui { -1 r h j 3� s_ ` I '.' ..
i_} I . E ^h .' I is • l '{- .
. „
Plan Che #
CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Recd 3
TIGARD, OR 97223 Date to P.E.
(5G3) 619 -4171, x304 Date to DST
Print or Type Permit # MICA$ 4JIq
Called
Incomplete or illegible applications will not be accepted
Name of Development/Protect Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suites A) Permit Fee -0- -0- • 10.00
Address 1110 .Suittt e 2 LA-Ke - 7C.
Bldge City/State Zip 1.) Furnace to 100,000 BTU 6.00
. T 1 6PteD i7 including ducts & vents
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner TM A-2l( 2C PC) (6 ( N S including ducts & vents
Mailing Address 3.) A � - 3.) Floor Furnace 6.00
11 1 10 S 5 : _ \ ��!. inmeR LA ' � _ - b� including vent
city/state Zip Phone 4.) Suspended heater, wall heater 6.00
- n (? 3 9 - 77. . 54ci -368 f or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing E 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP: absorb unit to 100K BUT
City/State Zip I Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP: absorb unit to 500K BTU"
Contractor N8f1e Ai err - p 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to -T 4 k' 141€ Z, / 11 k? Aeras 15-30 HP; absorb unit.5 -1 mil BTU"
issuance Mailing Address n^ 9.) Boiler or comp, heat pump, air cond. 22.50
applicant i 15:q , ` c
,SLR) CA 4 01 3 et' 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all • /state , Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor r Pfilt PAN R '/OOS 6724,44S > 50 HP; absorb unit 1.75 mil BTU"
license regon Const. Cont. Board l.ic.# Exp. ate 11.) Air handling unit to 10,000 CFM 4.50 •
information 1 a / / (0.5 .3/ ? /9 8
for COT COT Business a Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database). L/ Tax
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer city/state Zip - Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration K Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional Description of work 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
Incinerator
Existing use of C /�� 19.) Repair units 4.50
d
building or property (,7)�. 7 /1 - L
20.) Wood stove 4.50 4
• Proposed use of 21.) Clothes dryer, etc. 4.50 '
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas V LPG 0 electric 0 23.) Gas piping one to four outlets 2.00 °P
-
I hereby acknowledge that I have read this application, that the 24.) 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 .= of Owner /Agent Date *SUBTOTAL O
i •
w 3 / T / 9 R 5% SURCHARGE Ic a'
• ntact Person Name hon PLAN REVIEW 25% OF SUBTOTAL
624466-.2- TOTAL ^
i:ldst mechpmtdoc (rev 9 *Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
f Date Requested > U AM PM BLD �7
Location // /U.-C ,S 9 7 (G,. (/
Suite EC �Q - ad F 5`
Contact Person CJ) l'/=S Ph e 2.? - - S C I? ( PLM
Contractor Ph 5 - 36 t/ ( /f) SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Foundation I NOT REQUESTED FPS
Ftg Drain FOUND D URING RESEARCH
Crawl Drain SGN
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post & Beam
Ext Sheath /Shear
Ina Sh /Shear
Framig '� .-S/� /� Tic 9 ��
n
Insulation I J
Drywall Nailing
Firewall •
Fire Sprinkler
Fire Alarm 7 (-5 Cc .1
Susp'd Ceiling
Roof 1
Misc:
Final
PASS PART FAIL
PLUMBING Post &Beam r
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANIC L
Post & Beam
Rough In
Gas Line
Smoke Dampers
roar,
�41§1-' PART 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 3 '3 - d 0 Inspector V C� Ext 3
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.