Case File r
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12254 SW AN'M DRIVE
il�ICc�
l CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
I BUP
_Date Requested _ --AM-----PM � BLD
Location 17 Z 5Z-'r r�T �� ` Suite
Contact Person Ph PLM
Contractor Ph SWR
BUILDINty - Tenant/OwnerELC
Retaining Wall — ELR
Footing NCT REQUESTED —A
Foundation FOUND DURING RESEARCH FPS _—_--
Ftg Drain
Crawl Drain NO INSPECTION(s) IN FILE SGN —
Slab SITPost& Beam ----- - —
rt Sheath/Shear _
Int Sheath/Shear
Framing
Insulation --
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _—_---- - ---�-__— -
Roof
Misc:_ _ - -— -------- ------ -- ---- -
Final — —
PASS PAR1 FAIL --------- --- --------- -- -- ------ - —
PLUMBING
Post& Beam — -- --- - --- --:. --- - -— ---- ----
Under Slab
Top Out ---- --- - _ ----- _ _ --- --- ---
Water Service
Sanitary Sewer - - --- -- --t--- ----- -- --- ----------
Rain Drains
Final -- ---- --- - --- -- -_
PASS PART FAIL
MECHANICAL
ftst&"G am —— - ----- - -- --—-------- —
Rough In
I
Gas Line ---- - - ------ ---
Smoke tampers
-AS
- — --------- ------
[ S PART FAIL
�F'LECTRICAL -------__...--
Service
Rough In -------------------
UG/Se b
Low Voltage --
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading -- --------- ---- --- ------ -
Sanitary Sewer
Storm Drain [ J 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
Other Date —. Inspector_ _-_-_ Ext _
Final --
-PASS PART _ FAIL 00 NOT REMOVE this inspection record from the job site.
CITY OF TINA RD
=TWA MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . . IvIST-93-00 I i
13125 SW 14WI OW. P.O.Box 23397,TigmM,Ovegon 97M (603)63"176
639-4171 DATE ISSUED: 01/28/93
SITE ADDRESS. . . : 12254 SA ANTON DR PARCEL: IS134CB—AV1105
SUBDIVISION. . . . : ANTON PARK #2 ZONING:
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 105
BUILDING
REISSUE: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 s
CLASS OF WORK. :NEW BEDR115:4 BATHS:3 GARAUE. . . . . . . . . . :450 s f
TYPE OF USE. . . : FLOOR AREAS---------- REUUIRED
TYPE OF CONST. -5N FIRST. . . . -850 S f LEFT. . :5 ft RIGHT. :5 ft
OCCUPANCY GRP. .-R3 SECOND. . . :944 sf FRONT. :20 ft REAR. . :44 ft
STORIES. . . . . . . :2 TH I RD. . . . :0 s f REQUI
HEIGHT. . . . . . . . t24 ft TOTAL------: 1794 SF SMOKE DEIECTORS. :Y
1::'I...00R LOAD. . . . t40 psf VALUE. . . . . 90624 PARK:(NO SPACES. . : I
Remarks: PATH I
PLUMBING
'*iINKS. . . . . . . . . . : 1 FLOOR DRAINS. . . . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . :4 WATER HE14TERS. . . 11 TRAPS. . . . . . . . . . . . . . ..0
TUB/SHOWERS. . . . 12 LAUNDRY TRAYS. . . 30 CATCH BASINS. . . . . . . :0
WATER CLOSETS. . 13 SEWEe% LINE (ft) . :0 GREASE TRAPS. . . . . . . :0
DISHWASHERS. . . . 21 WATER LINE (ft ) . slOO OTHER FIXTURES. . . . . :0
UARBAGE DISP. . . : 1 RAIN DRAIN (ft) . :0
WASHTNG MACH. . . : 1 SF RAIN DRAINS. . : i
MECHANICAL ------------------------------------ FEES
FUEL UNIT HTR9. . .0 type amount by date v e c p t
/GAS/ VENTS . . . . . :0 TIF $ 1460. 00 JH 01/28/93
MAX INPU1 :0 BTU VENT FANG. . :4 BPRT $ 406. 00 JH 01/28/9,3
FURN ( 100K . . : I HOODS. . . . . . : 1 BPLC $ 263. 90 JLH 12/28/92 235030
FURN ) =100K . . :0 WOODSTOVES. -.0 B5PC $ 20. 30 JH 01/28/93 —
FLOOR FURN. . . . :0 CLU DRYERS. : I SSDC $ 280. 00 JH 01/28/93 —
BOIL/CMP ( 3HP-0 OTHER UNITS: 1 PARK $ 500. 00 JH 01/28/93 —
GAS OUTLETSil MPRT $ 43. 50 JH 01/28/93 —
Owners $ 10. 88 JH 01/28/93 —
D L ANDERSON INC M5PL $ 2. 18 JH 01/28/93 —
4575 SW TUCKER FIVE' PPRT $ 140. 00 JH 0I/28/93 —
V'5PC $ 7. 00 JH 01/28/93 —
BEAVERTON OR 97005
Phone #i 6P7--9999
Contractor:
D ANDERSON, INC
4575 SW TUCKER AVE
BEAVERTON OR 97005
Phone #t
Peq #. . .- 46344 ......
313.3. 76 TOTAL
Thi,; pewit is issued subject to the regWations contained in the ——————— REUUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. Specialty Codes and all othsr Foot/found Insp Fireplace Insp
applicable laws. All work will be done in accordance with approvea Post/Beam StrUCt Gas Line Insp
plans. This pewit H.,:1 expire if work is not started within 180 Post/Beam Meehan Insulation Insp
Av5 of issuance. ur if work is suspended f 4W 18W days. PIM/Undslab Insp Gyp Board Insp
--PLN/Underfloor Rain drain Insp
chanical Insp Water Line Insp
-47'at 1(2 Plumb TO p 0 Lit Appr/Sdw1k Inst)
d E3 Framing Insp Mechanical Final
Ca '. 1 far inspect ion - 639-4175
SEWER LONNLC-TION
CITYOFTI(FARD ;CITY4641D V.,E R 111 T
7 13126 SW HWI Olvd. 9).0.Box 23N7,TOW.Onigm 97223(6W)6304176
SIT[-. ADDRESS. . . t 12254 SW ANT014 DR PARCEL: 1S134Cb--AP101-')
Owner: FEES
4573 SW "TUCKER AVE PRMI 2'10111. 00 JIA 01/26/93
INSP 00 JH 01/281/913
BEAVERTON OR 97005
P11-tone #-. 627-9999
CONTRACTOR NOT* ON FILE
PI-Ione #: 2135. 00 TOTAL
Pell
REUU1RED INSPECTIONS
1his Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expir,i IB@ dayj �rom
the date isslied. The total amount pAid will be forfeited if the
perrit expires. The Agencv does not guayantee toe accuracy of the
side stwer laterals, it the sewer is not iocated at the measurement
given, the installer shall prospect 3 feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency 4'"I'imsTill a late 11
� .
�Issi.ted By .
Lal1 for inypert iun - 639-4175
|
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� PLNCK RECT �
CITY OF TIGrARD 13115 SW Halllltvd / =
COMMI1N111' UI,VI:1.O1 MI?N'I' 1)1?i AR"I'MEN't'
Tigard Oregon 97213 PERMIT #
(503)639-4171 DATE ISSUED
Or
JOB ADORESS: '��✓�� 1A MAP/LOT s 3 Uc
SUB:Aka0/ lf� 2- -- LOT: �� � LAND USE:
VAl-UAIION:
OWNER SPECIAL NOTES
NAME: �� �, N',�' 2�r� ` REISSUE OF: _
ADDRESS: l 5�,, �/ �l/C-� > '` LAST REISSUE:
��,c t�,•°L� �y � FLOOD PLAIN/
PHONE: _- �1 /__� — SENSITIVE LAND:
CONTRACTOR APPROVALS M I_RED
NAME: PLANNING:
ADORE=S: -___._- ENGINEERING:
FIRE [DEPT:
PHONE: _ Y-- ------- --- OTHER:
CONTR. BOARD #: _- EXP DATE: -.z,�-
ITEMSREQUIRED
SUBCONTRACTORS: PLUMB: LIS1/SUBCONTRACTORS:
---- MECH: ���----- BUS TAX: ---- -
ARCH
�GINEER CALCULATIONS:
TRUSS DETAILS: ✓��NAME: ---- -- -- —
ADDRESS: __ OTHER:
PHONE: _ -- ---- -.
PROPOSED BLDG. USE: ----
COMMENTS: -
APPLICANT SIGNATURE
Received By: _ —_ _— Date Received: _ 1 Z .L� —
PHIN11 N ACCT k DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
Yrs .3 {1'r(j 10-432 00 Building Permit Fees
_ 10-431 00 Plumbing Permit Fees
_ 10-431 01 Mechanical Permit Fees Y3•Su
10-230 Ol State Building Tax (5%)
Building ?o.30
Plumbing -_-7,a0
Mechanical 2.1 Y
10- 433 00 Plans Check Fee Z,
Building 6, u
Plumbing
Mechanical _1U Sj'
10-230 0f Fire -
ilR<�3.gu/0,30-202 L Sewer Connection
30-444 On Sewer Inspection
25-448-02 Commercial TIF Fees _
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
25-448-01 Residential Traffic Fees 's o
25-448-05 Mass Transit TIF Fees _-
52-449 00 Parks System Dev Cnarge (PDC) 500 �� S o;J ._
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) ¢ -
24-445-01 Water Quality (Fee in lieu of) -
24-445-02. Water Quantity (Fee in lieu of; _
TOTAL SG 0
nm/3587P.WPF
CERTIFICATE OF
CNW17Y OF TIGARD OCCUPANCY
PERMIT 0. . . . . . . . MST93001 1.
COMMUNITY DEVILOPMENT DEPARTMENT DATE ISSUED: 06/10/93
13126 OW Hall Blvd,Tigard,Oration 972230800 (603�$39-4171
PARCEL: IS134CB--17800
SITE ADDRESS. . . 1 12254 OW ANTON DH ZONINO-
SUBDIVISION. . . . I ANTON PARK #c--'
B1.OCK. . . . . . . . . . I L OT 05
CLASS OF WORK. iNEW
TYPE." (IF' USE. . . I 9F
OCCUPANCY GRP. tR3
UCCUPANCY 1.0AD:224 4
TENANT' NAME. . . :
Remar-ksz PATH I
ClWrler-:
I) E. ANDERSON ING
4575 SW TUCKER AVE
BEAVERTON OR 97005
Phonp #t 62'7--9999
Cont ract at-I
D ANDERSON, INC
4575 SW TUCV,ER (WE
BEpvERTUN OR 97005
Phone te 627- 99 )4
Rpq *. . - 46344
occupancy of the above v-efet�enceci bUllding is het-eby given, and cer-tifleq
thp c.ompliance with the State Of Ov-eg( .1 Specialty Cudes fat-, the� t.jl"01-tPi
occ.jjparicy, and use under� whi,:Ji the refev�pncecl permit was i %SLted-
FIRE DLPARTMENT B IJ fL 11; IN 'PECTOR
FF I C I 11roL.
POST IN CONSPICUOUS PLACE
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd.Tigard,Or*gon 97223*8199 (503)639-4171
ll';"-'4 SW At
ANTON Pn-RK *r-
LOT. . . . .
r-1.0011 FURN. EVAP
UNIT HEATFRE, VENT rANS. . . :
GUP(INCY (-.44"'. R," VENT5 W/0 AP';-'L-^ VENT GY-OTEW,.
S. . . . . . . . 2 BOILS /COMPRESSOPS F40ODS. . . . . . . .
r- ILI I irl. DOME J. INCINt
15 HF'. . . . . COMML. INCIN:
-TU 1") 30 1 IF, . . . . Rcp,oirz UNIT),.-
0 1'7;Cj p L 50 Hr'. . . . . WOODSTOVES. . .
PRE50URE. Hr-",,
OF AIR HANDLING UNIT„T OTHER UNITS. :
RN; t 101, t 10-012'e, Ifni : (-Xi", OUTLET-!.
-10V 10000 cfrl . 1
i L�'.JAT IAL WIP -COND1 7 rj!'; Ul" , I
FEES
t -.I m 0 u.n t by d tt
P,R m'r s L'5 0 CA SW
W
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City of Tigard MECHANICAL PERMIT PlancWRec. #
13125 SW Haff Blvd. APPLICATION Permit # (tiC�i`� D131
Tigard, OR 91223
(503) 639-4171
M» escripuon
Hant) S U cber Tabio 3A Mechanical Code OTY PRICE AMT
Job1 �.of�J� SW ►"L t D11 lam►' 1) Permit Fee 0- -0- 10.00
Address — -- --
ILACUrd O g 1 a a 3 2) Supplemental Permit 3.00
ruriesce a
BTU —
t°I Chu 524-o54 1) 6 md.duct's a vents 6.00
«• --T urnace 16u5 TUTU —
Owner I a a54 2) Ind.duds b vents 7.50
— Flo—Funianoe
HLL ar d R G a3 3) incl.vent 6.00
µ».4 Suspended hentor.wall eater
r�0ns ocher 524-0Sy1 4) or floor mounted heater
nVont not .in
Occupant a a5 4 3W An-t n Cr. 5) aplofiar,cs permit 3.00
15repab � hmaflnfl,re ng.
L acrd 0 K q-7-�--13 6) cooling,absorption unit 6.00
-- mow comp,hoat lump,air coni - —
�at1riq--r-&. Cm j_ 7) to 3 IIP absorp unit b 100K DTU 6.00
o Boiler of comp,TWaf pump,au con
Contractor 16(X)0 SE Evelyn Street 8) 3-15 HP 00
absorp unit to 5K DTU - 11.00
w Bailor or comp. moat rxamp,av wncT
.lackamas OR 97015 9) 15 30 HP absorp unit.5 I ml BTU 15.00
w ••b^ 'T ter of comp, moat pump,mr
7187f3 10) 3050 HP absorp iron 1-1.75 mil BTU 22.50
mer �y a-czow go mat have raa�thTs ap ication, t me i er a comp,T'at jumpcomic
rm ,air
Information given is correct,that I am die owner or audroriteu q nt 11) >50 HP absorp unit 1.75 mil BTU 31_50
of the owner,that plans submitted are in compliance with State r man ;g urn W
laws.dint I am registorod with die Construction Contract-"'t Board, 12) 10,000 CFM 460
that doe number given is correct. (If erempl from State registr.htion, -- �r i g unit
ploase give reason below.) 13) 10,000 CTM+ 7.50
-
141 evaporate cr-Arif 4.50
Vent Tanax nocQ--
15) to a singlo dud - 3.00
— Vontiabon system not
16) included in appGanao prmnit 4.50
• t a` -----___��--_ o SMvv by ___----
`�-JC 17) medmanical exhaust 4
--- 4.50
Describe now n Ilton n to•,ition la m-priiifCommercial sbta
to be dome residenbal R non residential Q 18) type incinerator 30.00
Existing use o mer t.e., siove,water
Widing or property M-1 19) heater,solar,dodmos dryers,etc. 4.50
Profmod use of J , ,�, 20) Gas piping am fax outlets 2.00
bul44ing or property KJtyIUI�LI ) L ---- --. . - -- -
Type of fuel -of(7 natural gas Q LPG Q electric U 21) More Min 4 per outlet
NOTICE
Minimum Fee$25.00 SUBTOTAL � 5 00
PERMITS BECOME VOID IF WORK On CONSTRUCT ON -
AU THORIZED IS NOT COMMENCED MT141N 180 DAYS,On 5%SURCHARGE
IF CONSTRUCTION On WORK IS SUSPFNDED On — —
ABANDONED FOR A PERIOD Of: 180 DAYS AT ANY TIMF PLA'I nEVI W 25%OF SUBTOTAL
AFTER WORK IS COMMENCED. — -
TOTAL 3: 5U
Spedal Conditions --
r-' j
Date Issued -) 1 I C�^by
�N1fO1oM1 �'
.w.few.W.
J
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A-TEMP
Heating & Cooling Inc,
16000 S.E. Evelyn Street Clackamas,Oregon 97015 (503) 650-5014
FAX: 557-2990
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