Permit ✓._ C T Y T i*1EC1Atd'ICAL
i_ ,e \ ' - D EVELOPMEN T SERVICES.
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PERMIT al.. . o e M >_G � - rZ1�l�,:s
1 3125 SW Ha11 Blvd., Tigard, OR 97223 (503)_639 -4171 DATE 7 S S! E D 0/05/97
r'ARCEI_, . '1S1 12r'�'t'Zi
s:t TE D1 F E'
S . e 13.470 S� SUtT mER'�+IGGD DR . *POOL. ..
S h,FsD .t V I E ION. SCI-- IGL.LS FERRY' ROAD TGWNHC1fYiE'Ei. ' Z,ON INS R -,=, '
•BLOCK'.: - „ • - ', r .; . . , , •• LG"I '.. - ;0IZrA.. '.`.TtJF?I- 3DICTION - T'1.0 . ' • '
•
CLASS OF 'HWOR3•'(e . g•NLW 'I'-L:OOR 'F1IRN„ 1:...'; ' .'EVA C••GG{.._CR3: r1.0,' ,
TYPE .OF'_ ;LJSE :e . ;'S't , UH r r rIEATERS,o s "0 '' " • VENT - FN'- NSA. ; ,.. 3 •.
GCCUP 1NC'Y ; � • 'C.RP., n B , ' VENTS''' W /Cl. PF-:P'L t . • 'VENT SYSTEMS ; 0 '
3TGR E: S '.'. . 0,- - BO I,LERS /COMP,RESSGRS. ' • . HGG1 _ 1 • ' ,
.. ..
r''1:L_ : TYPES-- ............_ --..-'-:-7-L-- 0 -(1' HS'... ,. „ . DOMES. INC IV-Vg ,rZi -. . • . , • ,3 -15 HP'. , , . •„ ' ' • - ' CGMML.e INCItve 't
A v o f r r_ !�� 1 i-. 1• -
i 1`1r/.� I C�lr � !T = . 0 ,BTU . 1. � - Sr,'_t I��f- . � ; 0 ' F ?E� ='r,.i R 'UN I7�5 g �4.� _ ,
e
ti.
F I RC D€ii 1i- r. RS .., . . '' ...,4_ ,..,1_{ H ... W C D,� -c
GAS PRESSURE.... 504 . "'HP. , ... 0 ' . CL G ' DRYERS'. . ' • ;,
N7a ,Gi= UN' TS-- "- -- - -- - -' -- ,, AI'R 'HANDLING LUNITS OTHER ,UN.I,TSa'-a 'rZ{' •
FURN (, i rrlZiv I3TI!'. 0 , . '(,_- l.00 c:fm ° ' GAS, L;LH L ., -: , '
FURN > = 1:00k BTU o a • > .`1= OQi{ZI�ZI � c'f= m.. 21
Recri ' 'Ssriraings'p & spa (located.b lots 39 &•4 3:
1?OWEf� .'13EVEC G `t(;= h�T ' .:- . Yt'�'ne - aorbL�a'nr. •- by do -1 -e• .,, : -se ~
15075 SW';KO _f_ PKWY S E 1'i .Ir RMT ,a 0. 00 ,Js p 1'i•/ 05 97 -3 7- 3 17,10 7,16, '
BE :AV' ER1 fN 0 R '97006 ` • ..Ji''CT $ ' . . 1.::a4n 35U 1 i /I? +5/'91' 97- x,00706 '
• ., PI one . ' #* • � ' , - ' i • • • 1. -'
- iY
C 'ITOL. HEF TI;!:3. TNC . . . -
P BOX 7331 _. --- .....__._�.___._.___._. _.._. _._. __.. ..__
Or
al. �1.' 50, ,'TOTAL.
SALEM GR 9731Z1' r r
Ph cm e tk.o 139-- •L�450' ,
Rep 44 . 1 00a IZI CI
. • _ - _...._' REQUIRED r .i `,_. ',
' Thi- s, 'peteit is issued subject' t,o, the r'egulations,.contained in the ' .h'iechai) ica1.'' ,iiis ' ._ ' _ _.. . ._....�_ - __
Tig rd,. unicipal L ode s Sui te of Ore. Specialty Codes. and0'all other Heat i n, r' lin`L ,.I n :sri _ _ _
pl
apicabie.la:s. All work wil l, be do " Tis
ne in accordance yJith • DucL - T,rc_
et'ion' ,
C.P proved' plans, ' pet will expit'e if is not started' ' • F'i'na:!. - 'Inspect ion • - ,
, ' ' "'i8>7,', days o'f .issuance or if work is suspended fo'r• more , ' - -. -
than lip' day s: ' ATTENTIONe Dr-et la.i .requires your to follow. rules , _
adopted by'the Oregon Utility Notification Center. Those r1 S al '' _ � '
s'et ' forth'' in OAR 952 -Ni- 10 throu jh DAR 35 2- t�@i- �rZ8r3: You 'gay _ ��__
LL_.': ' of LL l '� L 1 _ '
obt ief caries of theese'ru es er, direct 'Que. L.i'ons to•DUNC "by calling , - .. - - '
(5012467j187. ® ��___. ___ -_ _ __
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h., Cal 1 :.i.3.39'7. 4173 6v O '•po m ' ol' -' - n ;spec - .: oyrr, neeJ.ed': th,e .' 4 I.ta.�.rfe_s'- •• .
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Plan Check N 4
CITY tF TIGARD Mechanical Permit Application Rec'd By
1125 SW HALL BLVD. Commercial and Residential Date Rec'd ti 7
• TIGARD, OR 97223 • 6UPq 7" Date to P.E. K.1
(503) 639 -4171, x304 0 L ° Date to DST . a
Print or Type Permit # 1 -. -- D 33
Incomplete or illegible applications will not be accepted Called Mir
Name of Development/Project Descnption
StiMMg7.4kle T 14 HOJvlOh. Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee
-0- -0- 10.00
Address L 1 -70 40iMr 00j)
P Bldg# // City /State Zip 1.) Furnace to 100,000 BTU 6.00
M 17 1 ( 01 T]'Jj including ducts & vents
Name (or name of business) 2.) Furnace 100,000 BTU+ ,/ 7.50
Owner Rowell riki�J u�(� N 1�.to including ducts & vents - 15.06
Mailing A dress 1101242417014 3.) Floor Fumace - 6.00
I'1i(7 C 71A) I J%i In't'o including vent
City /State Zip Phone 4.) Suspended heater, wall heater 6.00
'� o N v9 O�1.i o4 21404 or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
/MMz NS f.1,01,6
Occupant ailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City/State zip - Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP: absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
-
G� IrpL . 'fir) 5 � "l 15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit Mailing Address i 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy F., -751 3 30-50 HP; absorb unit 1- 1.75mi1 BTU** of all licenses Cdy /S tat a Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if ya1,EN1 2 -f 1.}0, 00& 50.3 56 -110 > 50 HP; absorb unit 1.75 mil BTU"
expired in COT Oregon �Co ont. Board t_�e.# Exp Dat 11.) Air handling unit to 10,000 CFM 4.50
database 1 14A,
Architect Name 13.) Non - portable evaporate cooler 4.50
rrA4 IT '--
Or Mailing Address 14.) Vent fan connected to a single duct 3.00
1024, �J Moruz44er1 I 3 . 0 0
Engineer ity /State Zip Phone 15.) Ventilation system not included in 4.50
PO 0 '2-2 "5151 appliance permit
Describe work New Ad ion 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential Non - residential 0
Additional Description of work: 17.) Domestic incinerators 7.50
P i. 1400W - v rax� e)12-14/: ,� 18.) Commercial or industrial type 30.00
�jy�
T Pr p�V 1 1i IN9TALt.) FaVe0) Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas e/LPG 0 electric 0 23.) Gas piping one to four outlets 2.00 o %
a.
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.
Signature of Owner/Agent 50.00
/Agent Date *SUBTOTAL
\/ 1 p 25 -k 5% SURCHARGE I �
Co tact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
M.414.124-4 4 711)40,11 1 -1111 5 457.1, TOTAL 3(.5D
/
i:lrmechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit.
(61 (1
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 j 1
Date Requested: G' 4' [ g A.M. P.M. MST:
Location: ( -7D $(,() BUP: IF — a ��
en
Tant: SUANV WOOD Gl�(4 , uite: Bldg: MEC:' a OIL
Contractor. Phone: 52- ( 4 — G ga. PLM:
Owner: Phone: (...570. + `7 ELC:
(nA.(��/I r i
/ / ELR:
i
AbIk...... ' / , /I .1 . ,' M. S :
BUILDING 411111111111111Rigl MEC If CAL : x
Site ost/B m Post/Beam / , Cover /Service Sewer/Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Toga ` t � � . Gas Line Rough -In UG Sprinkler
Foundation Insulation ` Y `4' Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire • • u Crawl/Found Dr Heat Pump Low Volt
• 'proved Approved ' Approved Approved Approved
Appr/Sdwlk , I7.41 DIP • ved Not A s t Approved Not A ip[oY � ' of Approved
FINAL V �' FINAL •
A -t ..—..."- 5 N--..y.__& G---(2- f. ' r--1-
(0/4V kg.f) U(A,..--,c '‘).}N- .
1
0 Call for reinspection D Reinspection fee of S required be ore next ins tion 0 Unable to inspect
Inspector. � v ` Date: la 5 Page of
r
1 1 -6-6---( 4i--or,_€_,Lei_o____-/
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: CP l ( 1 V A.M. P.M. MST:
Location: I _ _ ii1 AIL CA £ Oir.I BUP:
Tenant Suite: /
�� as • MEN �'( 33
Contactor. /}11 /n.c� � Phone: - - : PLM:
Owner V� Phone: ELC:
I 4 1 ELR:
_ &g__ i`. A i i" 7 --- SIT:
BUILDING ; i on) PLUMBING 61 a ' Ilea ELECTRICAL SITE
Site ' ' :: - : �:i Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab !
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pum. Low Volt ( ( J
A ppr ov e A • .. • Approved A y 9 • :•
Appr /Sdwlk o Ap ved ' Not Approved Not A roved Not Approved ` of Approv - • J `
@1/0 — O$C7k -' \A -(Ll .l C 5 - 1 - ,
FINAL FINAL ' I ` 1 a. §/ I i. .
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UAL
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c r...4 l_e____ - ZA, C -- N \ -K"•--‘ All J`e( C., -e-
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Call for reinspection O Reinspection fee of $ require fore C
next • on O Unable to inspect
,
Inspector: 1 1 (./� Date: \ ��� Page of
I
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