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10925 SW CHATEAU LANE — 10925 SW Chateau Ln. — CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175/ Business Line: 639-4171 - BU —�,-----Date Requested q11 Z --AM PM _ --- BLD — — — ' Suite — ---— _� Location _ I MEC Contact Flerson Ph PLM Contractor Ph SWR BUILUING Tenant/Owner _ _ _ — — ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain — Crawl Drain Inspection Notes SGfW Slab - - ----___.___ ------ --- SIT Post& Beam Ext Sheath/Shear Int ShealhiShear Framing - -------- ---.— Insulation - - -- _.-- Drywall Nailing Firewall �, j) Fire Sprinkler -- Fire Alarm Susp'd Ceiling Roof �7 i Misc: Final PASS PART FAIL -- -- ----- ----- -- - - ---- PLUMBING Post& Beam --- Under Slab Top Out -_. r.. ------ --- -------- Water --Water Service Sanitary Sewer - ---�--- Rain Drains Final - -- PASS PART FAIL _- ------__ ---- - MECHANICAL Post& Beam --- ----- -------- --- Rough In ._._.— Gas Line - ---------_--... --- ----_ -- - Smoke Damper., Final --.� ---- - -- - -- --- PARX,FAIL ECTRICAL — - "-- — - -- -- Service Rough In --- — -- -- _ � --- - UG/Slab _ - - --- - - -- -- Low Voltage Fire Alarm Tr anal) -- -- --- - PART FAIL SITE Backiill/Grciding --- --�--- - — Sanitary Sewer Sto,m Drain j J Reinspection fee of _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin i ll f Please call Inspection RE Fire Supply Line [ J [ J Unable to inspect no ccess ADA / Approach/Sidewalk Other — Date 1' _Inspector - Ext Final PASS PART FAIL O NOT REMOVE this inspection record from the job site. CiTX OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 ----- - / BUP Date Requested_ ( AM PM _ — BLD Location /�' `1.. ` L' ��'f(�¢'lei s7u (/J Suite MEC Contact Person _ a ,� Ph PLM Contractor _— Ph !y( Z /7-5 SWR BUILDING Tenant/Owner _ Z41--p (W#01? Retaining Wall E I.R Footing Access: Foundation J / FP3 k. Ftg Drain Crawl Drain Inspection Notes: ,``f J SGN Giab 4 LI Post 8 Beare --__� _ _-- SIT _- --- - -- Ext Sheath/hear Int Sheath/Shear -- Framing --_ _— -----.-- ___ Insulation - Drywall Nailing _--___--- --- ----Firewall Fire - Fire Sprinkler Fire Alarm _ Susp'd Ceiling _- Roof - - Misc: Final -- PASS PART FAIL -- -- _ -- - -- ------ .. PLUMBING Post& Beam - Under Slab Top Out --- - Water Service Sanitary Sewer — - - _-- Rain Drains Final PASS PART FAIL. MECHANICAL _ Post& Beam -- Rough In Sas line - _ Smoke Dampers Final — ----- 1AIRFAIL - --- ELECTRIC A Rough In n UG/Slab Low Voltage — —� Fire Alarm Final `— PASS PAR FAI SITE Backfill/Grading - -- Sanitary Sewer Storm Drain [ )Reinspection fee of$ _ require before next inspection. P*ay , ty Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ Please call for reinspection RE. - - _ _ able to Inspect-no access ADA / Approach/Sidewalk 1 ' ',, Other Date -+. v Inspector _ �V ---- -- EXt _ Final PASS PARI' FAIL D NOT REMOVE this inspection record from the job site. 0 z V u m m w m ly m u w w w w !^y n o n y O O O O O O o > z x s x x s z z z° z° z° z O O O Q v z z z z O o o 0 0 0La O � m () c m a, m no w w w LU o n o r rn0 n a c� m AV/ N W d �� 10 n V r �o n v v cn 0) cl � � w G c n c o N [ U N LL � Q -- - fY O Q) n N N N 0 d a w w ll LL Nr) o 0 0 00 ri .A a Q Q I- Q U U C.) U U U a w w w w LLI w CITY OF TIGARD BUILDING INSPECTION DIVISION MST :24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP — Date Requested_ r r _AM __PM _ BI D Location �; I quite _— MF.C,,' i Contact Person _ Ph __ PLM Contractor Ph SWR BUILDING � Tenant/Owner __ _ EI-C Retaining W.jll — - v _ ELIR Footing Access: e Foundation FPS Ftg Drain — SGN Crawl Drain Inspection Notes. - -- -- Slab - SIT Post 8 Beam _._.________ -.___-.-------------------_____-- -- _— Ext Sheat,,."')hear Int Sheath/Shear - ---- Framing _ Insulation Drywall Nailing Firewall - -- Fire Sprinkler Fire Alarm Susp'd Ceiling - ---- - - ---- - - - Roof Misc: Final PASS PART FAIL ------ -- ---- PLUMBING Post& Beam Under Slab Top Out -- — Water Service Sanitary Sewer Rain Drains Final - - - - --- PASS PART FAIL MECHANICAL - __- _ _-------- -- __ -- ----—-------- Post&Beam - Rough In Gas Line Smoke Dampers Final -- --- -- PAS'; FAIL TRI AL Rough InUG:,/Slab Low Voltage Fire Alarm PART FAIL — SITF Backfill/Grading - — -- Sanitary Sewer Storm Drai^ ( ]Reinspection fee of$ _ ___ required before next inspection. Pay at City Hall, 1:1125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reir7spection RE: [ Unable to inspect-no access ADA Approach/Sidewalk Other Date _-_ �'_ - Inspector _Ext Final PASS PART FAIL DO PJOT REMOVE this inspection record from the job site. CITN Or TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST / BLIP _ —_ —Date Reyuestea_ AM PM BLD Location _ � Z�C-,Gtr `l,Ff+ Suite Cor rtact Person Ph _ PLM Contractor Ph SWR BUILDING Tenant/Owner _ ELC Retaining Wall ELR _ Footing Access: Foundation FPS Ftg Drain — Crawl I air Inspection Notes. — SGN _— Slab Post& Beam - — ------- -- -- — -- SIT ------- Ext Sheath/Shear Int Sheath/Shear Framing Insulation - — ----- - -- __ _---.—.-- ---._. Drywall Nailing Firewall - Fire Sprinkler —_ Fire Alarm - — Sl rsp'j Ceiling rtouf ------- ____ Misc: Final PASS PART FAIL --- -- PLUMBING Post& Beam - Under Slam Top Out --- — -------- - - -- Water Service Sanitary Sewer Rain Drains Final -- P PAtT-- FAIL _ Rough In ((/ Gas Line -- ----- — --------- Smoke Dampers Final PASS PART AIL ELECTRICAL -- -------- ---------- — _— Service Rough In -- --- UG/Slab Low Voltage — `--�— -- --- Fire Alarm Final �------ — -- — ---- - PASS PART SITE ----- Backfill/Grading -- -- -- -- Sanitary Sewer Storm Drain ( )Reinspection fee of$ _ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd Catch Basin Fire Supply Line Please call for r Inspection RE: — ( nable to inspect-no access ADA Approach/Sidewalk Other Date _ Inspector — Ext Final / PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. t M m m m m m » / ( 2 \ \ ? / w /-4 < § § 7 / ± = n o » ® p 2 i \ , G / m ( § J 2 E I f \ E 2 D n � lu o < (D W O � n t CL � h ) ( (ƒ 0 f O R q ? ° O m m§ m A 0 � � . ƒ I F ƒF F rI } J 7 $0 7 k & §cl m m m m m CL _ In m m m � $ a § § § j § \ § § § § § § $ CL ƒ E CITYI�� O� �I�Q�D - ELECTRICAL PERMIT PERMIT#: ELC2000-00408 DEVELOPMENT SERVICES DATE ISSUED: 7/21/00 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S115AA--05100 SITE ADDRESS: 10925 SW CHATEAU LN SUBDIV13ION: REBECCA PARK ZONING: R-4.5 BLOCK: LOT : 008 JURISDICTION: TIG Proiect Description: Installation of one branch circuit for new a/c unit. _ RESIDENTIAL UNIT _TEMP SRVC/FEEDERS _MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP/IRF.IGATION: EACH ADD'L 500SF: 201 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/SVC/ FDR: 601+amps - '1000 volts: MINOR LABEL (10): SERVICE/FEEDER _ _ _ BRANCH CIRCUITS _ _ ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1 st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: _ PLAN REVIEW SECTION 1000+ amp/volt: s >=4 RES UNITS: > 600 VOLT NOMI_NAL:_ _ Reconnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: LUTZ, LARRY D+ LIZBETH K OWNER 10925 SW CHATEAU LANE TIGARD, OR 97224 Phone: Phone: Reg#: FEES __ Required_Inspections _ Type By _ Dato Amount Receipt �Elect'I Service ^ PRMT DEB 7,'21/00 $37.50 0003866 Elect'I Final 5PCT DEB 7/21/00 $3.00 0003866 Total $40.50 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR 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 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 at(503) 246-1987 PERMITTEE'S SIGNATURE_ / ,�� ISSUED 6Y: 11 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: �• � 1 �7 / DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day Planeckk-# — CITY OF TIGARD Mechanical Permit Application Recd, '13125 3W HALL BLVD. Commercial and Residential Date Recd 77PT� TIGARD, OR 97223 Date to P.E. (503) 639-41'" (304 Date to D Print or Type Permit#Ai��-WA90 Incomplete or illegible applications will not be accepted Called _ )pment/Project Description Table 1A Mechanica;Code Oty Price Amt Job :areP!Address lune# A) Permit Fee 16.00 Address 1) Furnace to 100,000 BTU Bldg# City/Stale Zip — includingducts&vents 9.65 2) Furnace 100,000 BTU+ _ including ducts&vents 12.00 Numn(or name of business) / 3) Floor Furnace Owner 4 #+= /LV including vent 9.65 Mailing Aduress 4) Suspended heater,wall heater ///2 .5,(_(J Lfie.�� laor floor mounted heater 9.65 Cit /State Zip Phone 5 `./ent not Included in wi liance ermit 4.75 City/State Check ail that apply: 'Boller Heat Air 9l4 For Items 6-10,see or Pump Cond Qty Price Amt Name(o ame o business) foot .otes 1,2 Com 6)Repair units 8.40 Occupant Mailing Address 7)<3HP;absorb unit to 100K BTU i 9.65 60 cny/State Zip Phone 8)3-15 HP;absorb unit 100k to 500k BTU 17.65 Contractor Name 9)15-30 HP;absorb unit.5.1 rnil BTU 24.15 Prior toermit Malting Address 10)30.50 HP;absorb p unit 1-1.75 mil BTU 36.00 i-suance,a copy 11)>50HP;absorb unit>1.75 mil BTU of all licenses City/State Zip Phone 60.1 are squired if 12)Air handling unit to 10,000 CFM expired In COT Oregon Const Cont Board Lic# F_'xp D..to 7.00 database — 13)Air handling unit 10,000 CFM+ Architect Name 11.85 14)Non-portable evaporate cooler Or Mailing Address - 7.00 15)Vent fan connected to a single duct Engineer City/state Zip Phone 4.r; _ .6)Ventilation system not included in appliance permit 7.00 Describe work to be done: 17)Hood served by mechanical exhaust 7.00 New O Repair O Replace with like kind: Yes 0 No 0 18)Domestic incinerators Residential O Commercial O Modification O 12.00 Additional Information or description of work: —" 19)Commercial or Industrial type Incinerator 48.25 20) Other units,Including wood stoves NOTE: For Commercial projects only;Units over 400 lbs.,located on the _ 7.00 roof,require structural talcs.prepared by licensed engineer. 21)Gas piping one to four outlets 3 Type of fuel: oll O natural gas O LPG O electric O 22)More than 4-per outlet(each) .77 5 5 1 hereby acknowledge that I have read this application,that the information Minimum Permit Fee$50.00 SUBTOTAL given Is correct,that I am the owner or authorized agent of 8%SURCHARGE the owner,that plans submitted are in compliance with Oregon State laws. PLAN REVIEW 25%C*SUBTOTAL Required for ALL commercial permits only Signature of OwnerfAgent Date TOTAL 0 Contact Person Name Phone Other Inspections and F ees If_ ( I tom'7 1 Inspections outside o.normal business hours(minimum charge-two hours) $50 00 per hour r 2 Inspections for which no fee is specifically indicated (minimum charge-half hour) Foonotes for commercial projects only: $50 00perhour 1. Provide full schematic of existing and proposed gas line and pressure. 3 Additional plan review required by changes,additions or revisions to plans(minimum 2 Provide drawings to scale showing existing and proposed mechanical charge-one-half hour)$50 00 per hour units. 'State Contractor Boiler Certification required —Residential AIC requires site plan showing plaeemeat of unit I:1mpr...hperm.doc rev 11/1/99 �.L� \\\� L .r ...r ....�. `� � �T I r(( 1(� `(\ 1 r . , ,� `"`�., U� _. CITYOF TIGARD MECHANICAL HERMIT DEVELOPMENT SERVICES PERMIT#; MEC2000-00290 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/21/00 PARCEL: 2S 115AA-05100 SITE ADDRESS: 1092.5 SW CHATEAU LN SUBDIVISION: REBECCA PARK ZONING: R-4.5 BLOCK: LOT: 008 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: Y TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: P.3 VENTS WIO APPL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: _ FUEL tYNES 0 - 3 HP: 1 DOMES. INCIN: FLU _ Y _ 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITSOTHER t""!ITS: FURN >=100K BTU: <= 10000 cfm: G > 10000 cfm: AS OUTLETS: Remarks: Installation of a/c unit. Placement of a/c unit must comply with standard setbacks. Owner:_ FEES LUTZ, LARRY D+ l_L'_BETH K Type By Date Amount Receipt 10925 SW CHATEAU LANE PRMT DEB 7/21/00 $50.00 0003866 TIGARD, OR 97224 5PCT DEB 7/21/00 $4.00 0003866 Phone: Total $54.00 - — -_ Contractor: OWNER 07105 SE LOCUST ST TIGARD, OR 97223 REQUIRED INSPECTIONS Cooling Unt Insp Phoi)e: Final inspection Reg #: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all ether applicable laws All work will be done in accordance with approved plans. This permit will expire if wok 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 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189. Issue 6: its <� � Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next gusiness day F CITY CF TIGARD Electrical Permit Application Plan c 13125 SCJ HALL BLVD. Recd TIGARD OR 97223 Date Recd '7-.P/-ao Date to P.E. _ Phone(503)1139-4171, x304 Date to DST - Inspection (503)639-4175 Print of Tyne Permit# Fax (503) 598.1960 Incomplete or illegible will not be accepted Called _ 1. Job Address: I.1. Complete Fee Schedule Below: 1 Name of Development L47 Number of Inspections per permit allowed Name(or name of business)/02,9 � �,�v - , Service included: Items Cost Sum Address _ / /�/� Q2 72,�__ 4a. Residential-per unit Ci /State/Zi 1000 sq It or less $ 11775 _ _ 4 ry p --------- Each additional 500 sq.ft.or Commercial ❑ Residential ❑ Limited Energy $ 80.00 _ Each Manufd Home or Modular 2a. Contractor installation only: Dwelling Service or Feeder $ 72.75 2 (Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders Information for COT data base). Installation,alteration,or relocation Electrical Contractor _ 200 amps or less $ 64.25 2 Address 201 amps to 400 amps $ 85.50 2 City State_ Zip_ _ 401 amps to 600 amps $ 128.50 2 801 amps to 1000 amps $ 192.50 2 Phone No. Over 1000 amps or volts $ 363.75 2 Job No. Reconnect only $ 53.50 2 Elec. Cont. Lice. No. Exp.Date 4c.Temporary Services or Feeders OR State CCB Reg. No._ Exp.Date Installation,alteration,or relocation COT Business Tax or Metro No. Exp.Date 200 amps or less $ 53.50 2 201 amps to 400 amps _ $ 80.25 2 Signature of Supr. Elec'n 401 amps to 600 amps $ 100.00 2 Over 600 amps to 1000 volts. see"b"above. License No._ u Exp.Date 4d.Branch Circuits Phone NO _ _ New,alteration or extension per panel a)The fee for branch circuits 2b. For owner installations: with purchase of service or / 1 feeder fee. Print Owner's Name L '(. / L- Each br,mch circuit $ 5.35 Address 1,, z S _ ye-&e, ,�_ n)The fee for branch circuits ,� nC without purchase of service City State Zip_ %,222:4 2L or feeder fee. 5� Phone No. 1G� First branch circuit $ 37.50 Each additional branch circuit $ 5.35 The installation is being made on property I own which is not 4e.Miscellaneous intended for sale, lease or rent. (service or feeder not included) / Each pump or Irrigation circle $ 42.75 Owner's Signature L _ Each sign or outline lighting _ $ 42.75 Signal dreuit(s)or a limited energy 3. Plan Review section if required):* renal,alteration or extension $ 60.00 _ Minor Labels(10) $ 100.00 _ Please check appropriate Item and enter fee In section 5B. 4f.Each additional Inspection over 4 or more residential units in one structure the allowable In any of the above Service and feeder 225 amps or more Per InspectionPer hour $ 50 00 _ $ 5000 System over 600 volts nominal n,Plant __ _ $ 59 00 �- Classified area or structure containing special occupancy as described in N E C Chapter 5 5. Fees: 5� Sa.Enter total of above fees $ * Submit 2 sets of plans with application where any of the above apply. 8%Surcharge(08 X total fees) $ Not required for temporary construction services. Subtotal $ _ Sb.Enter 25%of line 8a for NOTICE Plan Review If required(Sec 3) $ _ PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED Subtotal $ IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OP ABANDONED FOR A PERIOD OF 180 DAYr ❑ i rust Account# AT ANY TIME AFTER WORK IS COMMENCED Totsl balance Due�a $ _L i 1dsls lirnm',rlcctric doc a CITY OF TIGARD 13I1!LDING INSPECTION DIVISION MST 24 Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP Date Requested d� �C(`y n�] ,/ --- -- PM BLD Suite - (��5C14 Location c^ � MEC Contact Person t'L ` �'� 4' dc: y�-.� — Ph f S3 �� PLM Contractor _ Ph _ SWR L3UILDING Tenant/Owner ELC Retaining Wall ELR Footing Access. FPS Fig Drain Crawl Drain In�peCti n N�teS: SGN _ v Slab l' . ( `,_C (: <. Post&Beam - SIT Ext Sheath/Shear I C6t ` N Int Sheath/Shear Framing i V t�i�U l�T �`�/a S lei lJl ti[ 400)JAe',F,-�T-- 7-0 Insulation Drywall Nailing _- 4 ,4"." C':, Firewall Fire Sprinkler Z_� 12.4_S t-IL-ft , 1-2 Fire Alarm Susp'd Ceiling /5- Roof Misc Final PASS PART FAIL - - - PLUMBING Post& Beam Under Slab Top out -- -- Water Service Sanitary Sewer -- Rain Drains Final ---- PASS PART FAIL. MECHANICAL Post&-Beam Rough In Smoke Dampers A PART FAIL ELECTRICAL -- Service Rough In UG/Slab Low Voltage Fire Alarm Final -------- PASS PART FAIL S1iE- - - - -- --- _- B-ickfill/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 I ]Please call for reinspection RE: _— [ ]Unable to inspect-no access ADA Approach/Sidewalk - Other Date ��"�' - ,��i Inspectorr_Ext Final PASS PART ^FAIL 00 NOT REMOVE this inspection record from the job site. CITYOF T I G A R D MECHANICAL PEPMIT DEVELOPMENT SERVICES PERMIT#: MEC1999-00487 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/161'999 PARCEL: 2S 115AA-05100 SITE ADDRESS: 10925 SW CHATEAU LN SUBDIVISION: REBECCA PARK ZONING: R-4.5 BLOCK: LOT:008 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STOR!17S: BOILERS/COMPRESSORS HOODS: FUEL TYPES _ 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1 FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Installing ga-, insert and piping Owner: _ FEES LUTZ, LARRY D+ LIZB,-TH K Type By Date Amount Receipt 10925 SW CHATEAU LANE PRMT BON 11/16/19 $50.00 99-319793 TIGARD, OR 97224 5PCT BON 11/16/19 $4.00 99-319793 Total $54.00 Phone: --� Contractor: FIRESIDE DISTRIBTRS OF ORE INC 18389 SW BOONES FERRY RD PORTLAND, OR 57224 PEQUIPED INSPECTIONS Gas Line Insp Phone:503-684-8535 Misc. Inspectioi,. Reg M LIC 0004097. Final Inspection ORIGINAL 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 doi;-� 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 adapted in the Oreynn Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0)80. You may ob,jin copies of these rules or direct questions to OUNC by calling (503)246-9189. c� i /1 Issue By: � Permittee Signature: , 4_� c;. t CGI: L� (VVg, t( Call (503) 639-4175 by 7:00 P.M. for inspections needed the net business day r i Plan Check#_ _ CITY OF TIGARD RECEIV4ftchanical Permit Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd _t5___97_ `>1- TIGARD, OR 97223 NOV 151999 Date to P E. (503) 639-4171, x304 Date to DS COMMUNITY COMMUNITY DEVELOPMENT Print or Type Permit# _C Incomplete or illegible applications will not be accepted Called Names of Development/Project Description Table 1A Mechanical Code Oty Price Amt A) Permit Feett 2Vfj!"V' 1600 Job Street Address C r�fLn t ` 1) Furnace to 100,000 BTU Address I (39 �C jh.> (-" sunett- .. including ducts&vents see footnote 1,2 9.65 Bldg# city/StateZip 2) Furnace 100,000 BTU+ _ including ducts&vents see footnote 1,2 12.00 Name for name of business) 3) Floor Furnace includin vent see footnote 1,2 965 Owner �,O.�c r ' � {• -— 4) Suspended heater,wall heater Mailing Address I or floor mounted heater see footnote 1,2 965 I oq �`_5 r l.�) �+tioL��'�ti.a L V; 5) Vent not included in appliance permit 4.75 Cayrstate zip phone Check all that apply 'Boiler Heat Air �y�r 11 Z L I V�f For items 6-10,see or Pump Cond Oty Price Amt -- Na for name of buslnPe,) footnotes 1,2 Contp 6) 3HP,absorb unit to 100K BTU 965 Occupant Mailing Address 7)3-15 HP,absorb unit 100 to 500k BTU 1765 cityrstate zip Phone 8) 15-30 HP;absorb - unit.5-1 mil BTU 24 15 9)30-50 HP,absorb Contractor Name _40b //�� unit 1-1 75 mil BTU 3600 t•"iYQvlf><Q D1"�} CL l V. _ 1J)>50HP;absorb unit Prior to permit Mailing Address >1,75 mil BTU _ 60.15 -_ issuance,a copy I) '�14� r 11 Air handling unit to 10,000 CFM of all licenses state � __ Zip Phone 7.00 ,re required ifrc�k _3 3 i� ►A'1 � 12)Air handling unit 10,000 CFM+ )ired in COT Oregon Const Cont Board Lic# Exp Date 11.85 ^� data 1 l)'�Jl r1 ^lf!? I `0 _1 3)Non-portable evaporate cooler Architect Nome 7.00 14)Vent fan connected to a single duct 4.75 or Mailing Address - - 15)Ventilation system not included in appliance permit 7 00 Engineer cnyista a zip Phone 16)Hood served by mechanical exhaust' — -- _ 7 co Desrribe work to be dine - 17)Domestic incinerators 1200 New O Repair O Replace with like kind Yes O No O 1 B)Commerce:I or industrial type incinerator Residential a Commercial O _` �_�__ _14925 19)Repair units P,40 Ili nal information or description of work _ I 20)Wood stovelgas FPlother units/clothe dryerletc r f I ( 700 NOTE: For Commercialro1 ects only.;Units over 400 lbs renuire 21)Gas piping one to four outlets _structural gas calpcs See footnote 1 _-_ 3 75 3 Type of fuel oil G natural gas O LPG G electric O 22)More than 4-per outlet(each) ?5 Minimum Permit Fee$50.00 SUBTOTAL C� t I hereby acknowledge that I have read this application,that the information °!°SURCHARGE 'a C7 given is correct,that I am the owner o.authorized agent of PIAN REVIEW 25%OF SUBTOTAL Required for ALL commercial permits only the owner,that plans submitted are in compliance with Oregon State laws ,- - TOTAL r_ Si naiture of Owne Agent Date Other Inspections and Fees: j � 1. Inspections outside of normal business hours(mininum charge-two Contact Perso Name Phone hours) $50.00 per hour 2. Inspections for which no tee is specifically indicated (minimum J� - ( soy } ^ it J J charge-half hour) $50.00 per hour Foonotes for commercial projects only: u 3. Additional plan roview required by changes,additions or revisions to plans(minimurn rharge-one-half hour)$50.00 per hour 1 Provide full schematic of existing and proposed gas line and pressure Provide drawings to scale showing existing and proposed mechanical *state Contractor Boiler Certification required units. -Residential A/C requires site plan showing placement of unit I Mecbperm doc rev 7/19/99