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11500 SW COLE LANE ?E, ^'E'q5:.RE�Ey--S u, IRECEIVED ARE BASED GESiGtirRS A55"."�E5 N� :.lAE,_- -!ter =-QR V:AR.A�"'C'ti'S. = ANY, N MAR 1. 3 � �2003 CITY OF TIGAR BUILDING DIVISION t 95 co I • • + I I ! • � 1 1 + I ! ! ! 1 1 I Q I ! I ' 0 32 . .. ................. I • Q I ei I • NOTICE: IF THE PRINT OR TYPE ON ANY i -1-11 r 1 1 I 1 j I I I f 1 I III 111' 1Tr7711 1 1 1 1 III III( r l T 1 11 I I T 1 I I I I I I f1 � 111111TI r[rII1 1111111 IIISII 1111111IMAGE IS NOT AS CLEAR AS THIS NOTICE Z II2 3 4 _ _ - 9 - 1 Cl 1. 1 12 IT IS DUE TO THE QUALITY OF THE - / ORIGINAL DOCUMENT 6Z SZ LZ 9Z � Z � Z EZ Z TZ OZ No.38 mob- (III IIII IIII Illillllliilll 1111 .III IIII IIII 1111 N1� 11II l l�Il 111 LNI IIII. IIID. Illi 1111 IIII NII Ilii illi 1111 INI IIII ILII :ILII IIII IIII IIII IIII IIII IIII IIII .LII � �� - i 1111 LlI( Llll LIIIII!!I I►► 11.11 l.11 l� llllf�li _ i to 0 o U) 0 O m !r ! i I i Ii I F 11500 SW COLE LANE CITY OF TIGARD MASTER PERMIT PERMIT#: MST2003-00103 DEVELOPMENT SERVICES DATE ISSUED: 4/28/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 SITE ADDRESS: 11500 SW COLE LN PARCEL: 2S11013A-00100 SUBDIVISION: ZONING: It-4.s BLOCK: LOT: JURISDICTION: '116 REMARKS: Adding 480 square feet to existing residence. BUILDING REISSUE CIISTUhI STORIES I FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGH7: 14 FIRST. 480 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND. of GARAGE: of FRONT 20 PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: THRO of RIGHT: 5 I,u OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: Sea of VALUE: 44,351 REAR: IS PLUMBING SINKS: WArE.R CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS RAIN DRAIN: 1 TRAPS. LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUSISHOWERS. I GARBAGE DISP WATER HEATERS: WATER I-INES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN<100K. BOIL/CMP<3HP: VENT FANS: CLOTHES DRYER: FURN—100W UNIT HEATER': HOODS, OTHER UNITS. 1 MAX INP, btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUT LETS. I ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER_ TEMP SRVCIFEEOERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 100n SF OR LESS: 0 200 amp: 0 200 amp: W/SVC OR FDR: PUMPIIRRIGATIOW PER INSPECTION: EA ADD'L 500SF 201 - 400 amp: 201 400 amp: tat W/O SVC/FDR: SIGNIOUT LIN LT: PER HOUR: LIMITED ENERGY: 401 600 amp: 401 600 alnp. EAADDL BR CIRSIGNALIPANEL IN PLANT. N1ANU HMISVCIFDR. 601 - 1000 amp: 601-amps-1000r MINOR LABEL, 1000.amp Walt: PLAN REVIEW SECTION Reconnect only: —� —4 RES UNITS: SVC/FDR>-225 A.. 600 V NOMINAL: CLS ARFAISPC OCC. _ ELECTRICAL•RESTRICTED ENERGY A,SF RESIDENTIAL B.COMMERCIAL AUDIO&STEREO, VACUUM SYSTEM AUDIO 8 STEREO. FIRE ALARM INTERCOWPAGING: OUTDOOR LNDSC LT. BURGLAR ALARM. OTH: BOILER. HVAC: LANDSCAPE/IRRIC: PROTECTIVE SIGNI.: GARAGE OPENER. CLOCK INSTRUMENTATION: MEDICAL: OTHR: HVAC. DATA/TELE COMM. NURSE CALLS: TOTAL N SYSTEMS: Owner: Contractor: TOTAL FEES: $ 1,022.51 This permit i;subject to the regulations contained in the QUANDT,LINDA J OWNER Tigard Municipal Code,State of OR. Specialty Codes and 14165 SW 115TH all other applicable laws. All work will be done in TIGARD,OR 97223 accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if the work is suspended for more than 180 days. ATTENTION. r lrpgon law requires you to follow rules adopted by the Phone. Phone: UIegU.'I Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throL'gh 952-001-0080 You Reg a- may obtain ropies of these rules or direct questions to OUNC by Calling(503)246-1987. REQUIRED INSPECTIONS Footing Insp Crawl Drain/Backwater Framing Insp Rain drain Insp Foundation insp PLM/Underfloor Shear Wall Insp Electrical Final Post/Beam Structural Mechanical Insp Exterior Sheathing Inst Mechanical Final Post/Beam Mechanica Plumb Top Out Gas Line Insp Plumb Final Underfloor insulation Electrical Rough In Gas Fireplace Final inspection Issued By : CZ Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day i Building Permit Application f City of Tigard _ �- - Date received: % � h- Permit no.:N y "..�[[ r� � ) Address: 13125 SW Hall 6� Tt d,O�t 72Z3 Project/appl.no.: Expire date: cit.),o/l/gwd Phone: (503) 639-4171 Date issued: [iy: Receipt no.: ` Fax: (503) 598-1960 Case file no.: Payment type: 1 Land use approval: L±2 family: Simple Complex: ❑ I &2 family dwelling or accessory 0 Commercial/industrial U Multi-family ❑New construction O Demolition 0� _ ddition/alteration/replacement U Tenant improvement ❑Fire sprinkler/alarm ❑Other: Job address: app W 10ie n - Bldg.no.: Suite no.: - - - - r Lot: Block: Subdivision: — _ Tax map/tax lot/account no.: - -- Project name: Description and location of work on premises/special conditions: Odder 4 a 0 Name: Q-L4 YO Mailing address: t IGOD S LAJice Qi 1 &2 family dwelling: ,L Cityi -� State: �a1 Valuation of work ......................................... S Phone: R-mail: No.of bedrooms/baths.................................. Owner's representative: AA iC,_-4 el Total number of floors .................................. Phone: I a:.: E-mail: New dwelling area(sq.ft.)............................ ___-- - Gnrage'carport area(sq.ft.) .......................... (� 1 Name: Samna- Covered porch area(sq.It.) .......................... —�__-- Mailing address: Deck arca(sq.ft.).......................................... - --- -- --- ---r _- . - - City: State: ZIP: Other structure area(sq.ft.).......................... - -- - Commercial/industriallmulti-family: Phone: Fax 1'.-mail: Milos VAIN tolls-- Valuation of work ......................................... S 5 Existing bldg.arca(sq. fl.)............................ Address:css name: Q�Q, -- - — New bldg.area(sq. fl.).................................. Addr - - Number of stories .� City: State: ZIP: ;.......... Phone: Fax: L'-mail: Type of construction..................................... CCB no.: - __ - Occupancy group(s): Existing: New: City/metro lic.no.: Notice: All contractors and suh-.ontractors are required to be licensed with the Oregon Construction Contractors Board under Name: ert bort DeS rl" provisions of ORS 701 and may be required to be licensed in the Address: I c� i �e - ,jurisdiction where work is being performed.if the applicant is City: p G n _ State:p� ZIP: 9�2 I exempt from licensing,the following reason applies: Contact person: I Plan no.: — -�- Phone:-31q— i{ q 111 135.3E E-mail: — - --- - - Name: Contact person: Fees due upon application.............................S Address: _ Date received: City: State: ZIP: Amount received...........................................$ Phone: Fax: E-mail: Please refer to fee schedule. I hereby certify I have read and examined this application and the Not all jurisdictions accept credit cards,please call jurisdiction for more mfomution attached checklist.All provisions of laws and ordinances governing this u Visa u Mastercard work will be complied 9tfi,1hcttt9ccffled herein or not. Credit card nun,t,er CT7Y�•-•"J 11 Expires Authorized slgna'tuurl�: w - ___ Date: O? Nemc ofof cardholder as Chown on credit card Print name: �i�— —____. _ -_�� Cardholdcr signature — s Amount Notice: This pennit application expires if a permit is not obtained "ithin 180 days after it has been accepted as complete. a0-461}(&UKOM) �a �,c ,�� Plumbing Permit Application City of Tigard Date received: Q % Permit no.: --- Sewer pemiil no.: Building pen-nit no.: Address: 13125 SW Fiall Blvd,Tigard,OR 97223 CiryojTigard phone: (503) 639-4171 Project/appl. no.: Expire date: Fax: (503) 598-1960 Date issued: _ By I Rccetpt no.: Ladd use approval:— --_ _ Case file no.: Payment type: J I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement J New construction Addition/alteration/replacemcot U Food service Lj Other: Job address: 00StAUe- �„�)'),Q, UescrOlon Qty. Fee(ea.) 'total Bldg. no,: Suite no.: - New I-and 2-family dwellings only: Tax map/tax lot/account no.: -- (includes 100 ft.for each utility connection) ---- SFR(1)bath Lot: Block: Subdivision: _ SFR(2)bath - Project name: q _ SFR(3)bath _ Cit /county: ard (NQS rt— ZIP: � .144 Each additional bath/kitchen Description and I cation of work on premises: _ Site utilities: Catch basin/area drain Est.date of completion/inspection: Drywells//leach line/trench drain_ Footing drain(no. lin. fl.) - Manufactured home utilities Business name: w /r _ Manholes �— Address: Rain drain connector _ City: State: ZIP: Sanitary sewer(no.lin.ft.) Phone: Fax: E-mail: storm sewer(no.lin.ft.) _CCB no.: Plumb.bus. reg.no: Water serv�cc(no.lin. R.) City/metro Hc.no.: Fixture or item: Contractor's representative signature: Abso tion valve _e— -- - --- Back flow tirevcntcr Print name: Date: Backwater valve — -- Basins/lavatory Name: _ Vf d/,1L�j ua rdf Clothes washer - Address: Dishwasher _ Cit -- Drinking fountain(s) --- Y - State: ZIP: Ejectors/sump Phone: Fax E-mail: Expansion tank _ Fixture/sewer cap - Name(print): q LAA {- Floor drains/floor sinks/hub Mailin address: _ Garbage disposal _ g (�50C)5W CD Hose bibb Citi ard. _ — State:p(Z ZIP: 9?a.�t Ice maker _-- Phone:!o -4 �3 Fax: E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) _ employee on the prop ty-I ovv per URS Chapter 4d7. Sink(s),basin(s),lays(s) Owner's signature: _ _ Date: ! 03 Sump Tubs/shower/shower pan Nr me: urinal Address: _ Water closet Water heater City: State: ZIP: I Other: Phone: _ Fax: E-mail: Total Not all Jurisdictions accept credit cards,please call Jurisdiction ax more infinmation. Minimum fee................ S _- Notice: This pemnt application U Visa MasterCard Plan review(at %) $ expires if 8 perm _it is not obtained ------- Credit card number: _ Fs ire within IBO days after it has t>len State surcharge(8%)....S , p — Name or ca of er shown on credit ea accepted as complete. TOTAL........................ S — _ t Cardhul cr signature Amount 440.4616(""COM) t Electrical Permit Application Date received: 3,6P3/0 Permit no.: S • �� -({,�C;/1 ' City of Tigard Project/appl.no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR 9723 Date issued: 0 Rccci t no.: Phone: (503) 639-4171 y' P Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: ❑ I &2 family dwelling or accessory ❑Commercial/industrial J M1lulti-family ❑Tenant improvement ❑New construction Addition/alteration/replacement J(hher: - 'J Partial .108 SITE INFORMATION Job address itw le- ] Bldg, no.: Suite no.: fax ma(ritax lot/account no.: Lot: I Subdivision: --_ -- Project name: WAindfDescription and location of work on premises: Estimated date of completion/inspection: �— — Job no: - fi ht _-- pee M.x Business nanlc: Description ea Tohl no.lna — — -- NewresldentW-dnekorwultl•fawllyper Address: dwellingwdt.lnclWesanwhedprge. City: _ State: LII':_ 9errkelwhalled: Phone: Fax: L'-mail: IOW sq.fl.or less 4 Each additional 500 s .0.or pion thereof CCB no.: Elec.hos. tic.no: _ Limited energy, residential City/metro[IC.no.: _ Limited energy, non-residential 2 Each manufactured home or modular dwelling Signature of supervising electrician (requiredi Unto Service and/or feeder 2 Sup.elect.name(print): Licc;I till I 11721M sc rt„ Services or Feeders—Installation, alteration or relocation: 20)(1 amps or less 2 Name(print): 0 Ma �up ndf 201 am s to 4W ams 2 Mailing address: 115l�C �W CIG—�LLV1rQ. 401 am s 10 6W amps 2 6(11 amps to IlxlU ams 2 City: (�r� State:Qa, ZIP: 9 �� Over IUIIO am or volts �- Phone: (p3 Fax: h.-mail: Rccanncct only — --- --j Owner installation: The installation is being made on property I own Temporary services orfeeders- which is not intended for sale,[case,rent,or exchange according to Installation,alteration,or relocation: ORS 447,455,479,6;,0, 701. 200 ams or less _ _ 201 ams to 4(x)amps 2 Owner's signature: __ Date: 1 03 401 to fillO anif, -- B inch circuits-new,alteration, Name: or extension per panel: A. Fee for branch circuits with purchase of Address: service or feeder fee,each branch circuit City: State: ZIP: B. Fee for branch circuits without purchase Phone: Fax: E-mail of service or feeder(cc,first branch circuit: Gach additional branch circuit: Mist.Orrvice or feeder not Included): U Service over 225 amps-commercial U Health-circ facility Each pump or initiation circle U Service over 320 amps-rating of I&2 U Ilautdous location Each sign or outline lighting 2 fhrnily dwellings U Building over IO,M)square fect tour of Signal circuit(s)or a limited energy panel, U System over M)O volts nominal more residential unite in one structure alteration, or exlcnsion• _ U Building over three slorics U Faders,4(x1 amps or more *Description: U Occupant load over 99 persons U Manufactured structures or RV park FAch additional hnrection over the allowable In any of the above: U Egress4ightipg plan U Other: Pct inspection _ Submit_--.seta of plans with any of the above. Investigation flee The above are not applicable to temporary construction service. Other Not.11 jurisdictions Pccept credit cards,please call jurisdiction for more a rarmatitm i4olice: This permit application Permit fee ......................S J Viae U MasterCard expires if a permit is not obtained Plan review(at __ %) S Credit caro number / / within 180 days after it has been State surcharge(11%).....S Expires -- accepted as complete. TOTAL.........................S Name of cardholder as s own nn credit caT— -- s Cardholder signature Amount 404615 MAXICOMI Mechanical Permit Application City of Tigard Date received: /?j QJ� Permit no.:4 r " Projcct/appl. no.: Expire date: t"jlr(if Tigard Address: 13125 SW Hill Blvd,Tigard,OR 97223 — Phone: (503) 639-4171 Date issued: By: Receipt no.: Fax: (503) 598-1960 Case File no.: Payment type: Land use approval: Building permit no.: III Will 0 J I &2 family dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement ❑New construction Addition/altetation/replacement U Other: Job address: p 5V4 U 1p MAL Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials,equipment,labor,overhead, Tax map/tax lot/account no, profit. Value$ ____ Lot: Block; Subdivision: *Sac checklist for important application information and Project name. Ua ridjurisdiction's fee schedule for residential permit fee. City/county:M' Yds N Ask -]zip: g12.a Description androcation of work on premises: Fee(ea.) Total Est.date of completion/inspection: Descri tionQty. Res.only Res.oni Tenant improvement or change of use: Is existing space heated or conditioned'?U Yes U No Air handling unit CFM Air con itioning Is existing space insulated?U Yes ❑ (site plan required)No Alteration of existing system Boilcr/compressors Business name: / State boiler permit no.: _ IIP Tons BTU/H Address: Firc/smo a dampers/duct smoke detectors City: State: 7_IP: eat pump(site plan required) Phone: Fax: E-mail: Instal reP ace umace urner _ CCB no.: Including ductwork/vent liner U Yes U No -- - Instal rep ace re ocate healers-suspcn e , City/metro lie.no.: wall,or floor mounted Name(please print): Vent for appliance other than fumace Mie e gerat nn: Name: Absorrrption units HTP U/11 _ L,i r�._�dA M!f— Address: (J�j'� s(A (`>n� Compressors _ HP City: -= State:Qtt 'LIP: �') Environmentalex rust an vent at on: Appliance vent Phone:63 -�} (,3 Fax: E-mail: -5—rycr exhaust Hoods,Type 1/11/res. itchen/hazmat c�,,�� hood fire suppression system Name: _j ^-. — 4 l.l� Exhaust fan with single duct(bath fans) Mailing address: Exhausts stem apart from heating or AC Cit Fuelpiping and distribution(up to 4 outlets) y: State: ZIP - Tyre: LPG__ NO Oil Phone: - _ Fax: F-nmil Fuel piping each additional over out ets Process piping(schematic require ) Name: Number of outlets - -- - —- - t,"er hied-a_p prance or equipment: Address: _ Decorative fireplace City: _ -- 1 State I/II' - Insert -type _ Phone: Fax: I -mobil, Woodstovc/pellet stove _ Applicant's signature. _ - bate: Other:ter: Name(print): Not all jurimlictions accept credit e ,please call jurisdiction for more inlirrmetioa Permit fee .....................$ J vise U MasterCard Notice: This permit application Minimum fee................$ credit card number expires if a permit is not obtained plan review(at _ %) $ _ Gapirca within 180 days after it has been State surcharge(8%).... $ Name of ca n rr u shown on ere t ca accepted as complete. - _ s TOTAL........................ $ Card older signature � Amount 440-I617 161WCOM1 SENA BY:Lewis & Clark 3-17-03 15:34 Lewis & Clark-+ 5038463525:# 1 I I E7MAR 2003 CleanV�hb;Ar Services —^ Otir enmtritment is clear. Fila Number 3enaitive Area Pre-Screening Site Assessment 1 Jurisdiction -74L rd Date 19 r �y- Map 8 Tax La: ASl /Wh ovioo — Owner i CW Site Address tGoo1101111111111, Tiear wt 9VAIL!J Contact _ Proposed ActiAty if ioAddress q r0 _ Phone 1503-631.4*65 OMolrl use only below We llne Y N NA S-; Y N NA (Al 13-3;t (* ❑ ❑seneltive Area Composite Map Li ❑ ® 9tormwater Infrastructure maps �'` Map#_ 2S/_4o A _--- as# 4 5/7 Y N NA Y N NA ❑ ❑ W Locally adopted studies or maps ❑ ❑ rLT Other 'Speoify Spedfy Based on a reiview of the above Information end the requirements of Clean Water Services Design and Cbnstructlon Standards Resolution and Order No. 00-7: ❑ Soositllve areas potentially exist on site or wlthln 200' of the site. THE APPLICANT MUST PERFORM A SITE CERTIFICATION PRIOR TO ISSUANCE OF A SERVICE PROVIDER LETTER OR STORMWATER CONNECTION PERMIT. ;f Sensitive Areas exist on the site or wlthln X00 feet on adjacent properties, a Natural Resources Assessment Report may also be required. Sensitive areas do not appear to exist on site or within 200' of the site. This pre- screening sits assessment doom NOT ellminate the need to evaluate and protect water quality sensitive areas It they are subsequently discovered on your property. NO FURTHER SITE A88E88MENT OR SERVICE PROVIDER LETTER 18 REQUIRED. THIS FORM WILL SERVE AS AUTHORIZATION TO ISSUE A STORMWATER CONNECTION PERMIT. ❑ The proposed activity does not meet the definition of development. NO SITE ASSESSMENT OR SERVICE PROVIDER LETTER IS REQUIRED. Cma ents: _ /��,.r1al �M:;7� y� cti.vQti 4nDe�ws ro ,6Q ,��e� Revlewad sy: Date: �31/9/G3 Returned to.Applicant Mall Fox Counter_ 155 N First Avenue, Sufte 270•Hillsboro,Oregon 97124 Date V Phone: (503)841Q-9521 •Fax: (503)846-3525 SY�Ed1�,�1!!hlY��r'!,C�441�rE •_ _ ,' �1-L4-0-3 l ,l a.fi Permit#: ,Address: DD (561 obe-C !'_- Issued by: Date: Statement: Information Notice to Property owners About Construction Responsibilities Note: Oregon Laxv, ORS 701.055(4), requires residential construction permit appli- cants rvho are not registered moth the Construction Contractors Board to sign the f illouing statement bgfbre a building permit c•ala be issued This statement is required � for residential building, electrical, mechanical, and plumbing permits•. Licensed architect and engineer applicants, exempl from registration under ORS 701.0/0(7), need not submit this statement. This statement %vil/he filed vvith the permit. I ill in the appropriate blanks and initial boxes 1 and 2,and either box 3A or 3B: I. I own, reside in, or will reside in the completed structure. 2. 1 understand that i must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3n. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who %%nrk on the structure must be registered with the Construction Contractors Board. OR 1B. i will be my own general contractor. 1r1 hire subcontractors, I will hire only subcontractors registered with the Construction Contractors _,,oard. If I change my mind and hire a general contractor. I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I her chN ccrtiA that the abo%a information is correct and that I ha%a read and do understand the Information Notice to Propert.j (hiners about cOnsIruction Responsibilities on the r•e%er•se side of this form. ,a---�_ _ ___- 5// q0 R_ (, uatu of permit applicant) i I>atr (White cohv to issuing agency permit/ilr. pink co/lv to appli(-ant) Information Notice to Property Owners About Construction Responsibilities bi,/r) mid!"I1 Aril!( ,, Ir) A.-of70-1J' OII'IICI'1 ,1711111( uN,II'I;r I I i i I; 111 v�'ull.`•l/I ilij1,'y bI,I/?,, ( i)li%,rv(vfm t onlrtrctO1'\ h/Illl•(I 1!i t,,( -,hlm I, it till ()l'i -0/ 0.i i) 5) V% ill-I i11ICAV I;(-III(. of Illakc 1 --!1h,taill fill Hill 1 \t'IIU:111 It,1111 l.'\I�llll!', ..il I I!!' 11! 1i„!'I, Ilft'hlll!t' b) h(..u!' ,,'\ilrc 1 lll1: t1,11'.t\,!ng i ,p(.)n:.lbililiv.,• jird mt;,Ib' I uuo-clil. EMPLOYER RESPONSIBILITIES: fI flet 111 1`.( i1 II),1 fC 1 11'ICII \\Ilii Illy (. l,ll:,lflllll„I) l �,1111,t11t,1 BOWL' lt) llll 1;11)14! 111 0l11\11tlClllli' (1(' a)• I`1111L 111 til\ )I!.,I llllli.Il�.'I nllprh\U11)CIll 1)1 fl f�' Illt'llll,l) ,Iflll111tt'. '.1111 \\111, til ItIU',l III•.I;Ilha�i•hl' rlllt',l to he an 1:mpl(,\Cr and Ill('1),,i tl, (nl fill t' \\111 he c11lplO\rc', \�the cin1110\Cl. \(,!I ntll`,I rnnll l\'\\ill;the(01111\\ilia • t t)rel;nn's\�ilhhtt141i11ntax Ims- A:alit'mpl(iver \Oil ntust«ithh'tltlink,oineiaxt-4,0(ml emhl(1\renllLesatthetirlll .n!I'I I\SL. ur I !I(I 1 (,n \\III hr Il lhlc ft,r the t:l\Lnvinr-nt%e\en il'vnti dun'I aettlall4 \\lihhC'ld the Ii\ from\.tieremhloo,ct'. Ill It'rnrttIt) l.c,IIItIle( llcp!,)nDept (1114e\c'imeat(W-801)1 Vile Ifflo I)Iql.\Inenit Itl\11ralice tai: \i,aI1 ell Ipl„'.CI \I III;IIU I'( pIII,tIf!•p.t\ 11,1\ IO1'title IIII'IO\Ilww Ill',11U rICC l'llll t,1•.l',O11 Ill:' \ilt�t .('t All t'n1It1„\::(• 1 111 (1101 1111Ormalion,call thuUregtm l:nlrlONnlent l.)epaomentat 17$-,i`24. . N nl 6crs'c(ImIli n',alma insurance: A nn(-'Inl)I,,,cl,�Ou alt ,ul?i�,,t t0 111c Oren\,n \\0 ,cr,'l'kill 1pCosation l.,it\\,and nlnst hlalll \\. It cl, lI-11111CtIN'tIIUl! iII-,[IIitII,:( It,! \,1111 l'IIII)It) L,•, II \,)II Iit,I It ,,htitltl\\t'rkCr,'C1,111pe11,;11I'll I1lll,;lll11111'C•\till 1119V I”I)l'lIa111C',;IIld\\til 11C Ilahll'ttif.JII L 1(1111)t:1„,l,11(,Ilt't)t Will CI11I)I)t\\.'C,11,11111111.I !h. I I'1-Ill t)v lfit vl'llIill loll. it fIi(' \(,'(irkel,'CI IIIIit'n411ion 0I\,I\Iu11 at 111c 11Cr,;Ir1111CnI M' �c1'\ Il;,;ll 01 -"898. 1 .S. Internal Re%cume Seri ire: \,an(nlph1 \L.I \1`11 Ill 1W \'.I1111wId it ticr:ll nlc('nle 1a\ II,,nl\nllll0\ce,'\\,fere. 1 ell\\ill Ill.- 11-1111t: I0t thr tit\Itu)Incill c\en 11)Ou t ldii't it\:tur111\ \\ithhrld till'tit\. l (11 llww inlOrmation,call the(eternal Reven!►l`rr\iCc -if 1-$6IL824-1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: ( miccolli lllill rice: A,IhcpermiI 111,1(1( I !,•t !In luI 1;:; I ,( n,u(:Ic,t, n,lhlc till W`11\ 111, an\ I,1111:rctO;IIL 'tl,'(Icl:':'1 Ill;tl !11,1', I'll Itri)lIvill 1('$tllr;lltelliwil 111f1'll `11 In't1CClloll• (.ial'tlil\ :11141 darliage intiuruncr: ( ('nl;1i I '.(,ul in,urlult(:'.! 'c'!t t0,cc I \I,n h.l\c at±ryu,lle irt,uranlx c0\cr. .,t cidcnl,anti(,ell„1011~ uch a, I'alling tOU1,,paint u\e)yprat .\\atcr llalnaw” thiel pipe punctures, lire,of \\t rk that 111104 tit: Il'-(It Ilc. I inu: It#--inlet•\ke eniplo)cc%: flake,lire'\Ou hacc,ut'ticivilt hnlc tO,uper\ise\ollf-emph,\ees. I'\l►t1'Ikv: Makt',Ills'\ollh;l\l'lh\'C\I)VI'l1,CI�)ACI;l,$,Ills ',11L'C'nlrill C(Illlr;lt.l(,I',to cmil-dlllateIlicNi,(,t'Ii,tolI,'tial -111;111(I1111I'd 1 I'adec. ,lid to lit tif\ hnildi1104 oilki7(i,attht'vtlrl\rt,htiate'tinitt m the\ c;tn it4::rfot't'li the tcgiiired ieyeetions It \(•u Ila\t ;nitliliOnal yuesliOn,. \\rite(It ,ell the t On,hu.liOn t (,ntractOrs I30ar(l fill ►Hit\ 1.11,10. Salem,t )Il u':!ltl_•o1 •111. ti 16,1 ) '1 he gnard is It,( :!lr(f ,ll !nn tiulnllict tit \1 00. in Salem. I iia i' SEE 35MM ROLL# 22 FOR LARGE DOCUMENT CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 r d INSPECTION DIVISION Business Line: (503)639-4171 MST . BUP Received _ Date Requested_ AM PM BUP -C.0— —_—_ — Location — Soo cz_ Suite — MEC Contact Person _ ---- Ph ( —) _ PLM Contractor— _ _ — Ph(_ _) _ SWR - BUILDING _ Tenant/Owner_— — — ELC _ Footing ELC Foun.laGon Access: — — Ftg Drain ELR Cra;:l Drain _ -- slab Inspection Notes: 31T —_.--_— Oost&Beam Shea, Anchors � — - Ext Sheath/Shear Int Sheath/Shear — — Framing Insulation Drywa' wailing — -- — --- --_ Firewall Fire Sprinkler ---- -- --- — --_ _— — -- Fire Alarm Susp'd Ceiling ---- -- �� - --- --- Roof Other: ------- --- — - — — ir PASS PART FAIL _BING — Post& Beam —_ ------------ —.— —_— Under Slab Rough-In Water Service ------ --- — —_ Sanitary Sewer Rain Drains - ------------ — ---_ — Catch Basin/Manhole Storm Drain — - --------- _ Shower Pan Other. ------ - --- — --- — Final PASS_PART FAIL - --- ----------- -- ------_ ME_C_HA_NICAL — Posi& Beam -------------- — --- -- -- -- — io 'ti lei .--._ _ ----- ----• Gas 1_1s. ------- -- Smoke Di npers -- _-- _—___-- -- --__ Final PASS PART FAILService ---- ------- — --- _ELE_C_TRICAL Rough-In UG/Slab -- -------- --- — - -- �- Low Voltage Fire Alarm --------- -- �_..� -- - --- --- Final Cl Reinspection fee of$—__ required before next inspection. Pay at City Hall, 13125 SW Fall Blvd. PASS PART FAIL SITE Please call for reinspection RE - - _ r� Unable to inspect- no access Fire Supply Line _ ADA ,� �� Approach/Sidewalk Date � Inspector Fact _ .__-- --- - - Other: Final DO NOT REMOVE this Inspection record fror" the Job site. PASS PART FAIL 1 CITY OF TIGARD 24-Hour BUILDING Inspection, Line: (503)639-4175 MST 3--- INSPECTION DIVISION Business Line: (503)639-4171 BUP Received Date Requested_.--7^2- AM- - PM _ BUP Location �-O"�- Suite _— MEC Contact Person _ � - _ Ph( ) j -� _ PLM Contractor — -__- _ Ph(_ ) - —_ SWR _BUILDING TenanUOwner ELC --- Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT — Post& Beam Shear Anrnors Ext Sheath/Shear Int Sheath/Shear _ Framing Insulation Drywall Nailing -- --- ---- - - Firewall Fire Sprinkler ---- ----- - Fire Alarm Susp'd Ceiling - -- - - - - - - I Roof Other: -- - - - - ------ -- - Final ART FAIL PLUMBBII PosF B� eam _- ----_._--- -- - Under Slab _-- Rough-In Water Service - ---------- ---- - --- SanitPry Sewer Rain Drains - --_....__--__-- ---- ---_-- -- - Catch Basin/Manhole Storm Drain ----- - --- -- — Shower Pan S. PART FAIL -. ---_----- -- ---- 1�4 ff-E HG AL Post 8 Beam -------- ---------- ------------ Rough-In ----- - - ---- --- - ---_-__--. Gas Line Smoke Dampers Final PASS PART FAIL -- ----- ---- _ELECTRICAL Service ------ - ---_--- . ..---- - -------- - -- Rough-In UG/Slab ---- ------ _—._-__-- Low Voltage --- - ---- - -- - ---- ------- --- Fire Alarm Final PASS PART FAIL �j Reinspection fee of$ -_---required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE - Please call for reinspection RE--- L I Unable to inspect--no access Fire Supply Line ADA - C� i Approach/Sidewalk Date �� _-- Inspe r �_Ext --_ Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST 3 INSPECTION DIVISION Business Line: (503)639-4171 BUP — Received --. Date Requested____ – AM PM BUP — Location __ __115 v�-_—d4-,e,2- - _-- Suite MEC _ - Contact Person Ph( ) PLM _ Contractor --__- -_ Ph(- ) —_ _- SWR -_ BUILDING Tenant/Owner _ ELC Footing - E ELC _ Foundation Access: Ftg Drain G-�"R p , ELR -- Crawl Drain Slab Inspection Notes: _ SIT — Post& Beam WS1 ` _ 3 1 Shear Anchors Ext Sheath/Shear -- —_ Int Sheath/Shear Framing --- ----- — Insulation Drywall Nailing — Firewall Fire Sprinkler -- -.-.._-.-.__--- - — Fire Alarm Susp'd Ceiling Roof Other:- - ---- - - - -- - ------ Final -- PASS PART FAIL Post R Beam Under Slab --------- Rough-In Water Service --- ---- -- - -- — Sanitary Sewer Rain Drains - -- — — - -- - Catch Basin/Manhole Storm Drain ---- -- — - Shower Pan Other. ----- -- - �ASS2 PART FAIL MECHANICAL Post& Beam Rough-In --- - - ----- --- - Gas Line Smoke Dampers --- - - - _ ---- -- -- - — Final PASS_ PART FAIL --- - -- -- __- - -- ELECTRICAL _ Service Rough-In ---- -_-- - — — -- UG/Slab Low Voltage - -- -------- - ---- - ---- Fire Alarm Fn8 [ I Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. 6AS \PART FAIL F$ _ � PlWcalliforection RE: _ _ Unable to inspect-no access Fire Supply Line ApproachlSidewalk pate __- Insp or ��4 l `-"` Ext- Other: Final DO NOT pEMOVE this Inspection recor from the b site. PASS PART FAIL CITY OF 'rIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171VBLD MST BUP ''Date Requested_ J �� j�j AM PM LocationSuite � MEC L: _- Contact Person _ ��` Ph 'y - 7 31'L _ PLM Contractor 1 r Z "''e Ph _ 7l ��.5!'� _ SWR BUILDING — Tenant/OwnerELC, ( Retaining Wall ELR Footing Access:- — Foundation / / / FPS Ftg Drain �GfL� ��trDL 6Q�K /.Gz�cY ( '+-� Crawl Drain Inspection Notes: SGN Slab SIT Post& Beam Ext Sheath/Shear Int Sheath/Smear Framing ALJ ��/�.s J7i/-'�r-* S � /. '7&57;1"= Insulation Drywall Nailing l S- AkI i QVC! S • '7-r1 ;+ --3 V — Firewall F=ire Sprinkler '0 7- Fire Alarm — Susp'd Ceiling Oc-- RCS Roof l Misc: �1,✓S;J�.�T1� `'Sy�r'�Y r?vc� Final — _ PASS PART FAIL PLUMBING Post&Beam ---- +— - Under Slab Top Out i - -- ---- __ Water Service j Sanitary Sewer — Rain Drains Ti Final - --- - PASS ART FAIL --_ Post& Beam Rough In _ Smo ci~e Dampers PART FAIL --+ 1ELECTRICAL Service Rough In UG/Slab ,Low Voltage —` --—___ `----------- _� Fire Alarm Final - -- -- � — — PASS PART FAIL SITE Backfill/Grading - --- - - — —_ Sar:itary 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: _— -- ( J Unable to inspect- no access ADA Approach/Sidewalk �-� Other — _ Date _� �- Inspector.X�A _Ext Final PASS PART PART FAIL_ DO NOT REMOVE this Inspection record from the job site. CITY OF T MECHANICAL DEVELOPMENT SERVICES PERMIT 13125 SW Nall SIM., Tigard,OR 97223(503)639.4171 PERMIT ##. . . . . . . : MEC39-0024 ,)ATE ISSUED: 01/14/99 PARCEL-: 2SI 10BA--00100 TF_' ADDRESS. . . : 1. 1500 SW CCI..-' ' LN 'IE-T.VI SION. . . . : ZONING): R-4. 5 . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TICS ASS OF WORK. . rAI_..T FLOOR FURN. . . . : 0 EVAP COOLERS: 0 OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 ,LJPANCY GRP. . :R3 VENTS W/O APF'I._.: 0 VENT SYSTEMS: 0 TORIES. . . . . . . . : 0 19OILERS/COMP RE=SSORS HOODS. . . . . . . : 0 TYPES._.._..---_--......-.._. ....... 03 HP. . . . : 0 DOMES. I NC I N: 0 3-15 HP. . . . : 0 COMML.. I NC I N: 0 MAX I NPUT z 0 BTU 15--30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS?. . : 30—.50 HR'. . . . : 0 WOODSTOVES. . : 0 � A 9 PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF r1IR HANDLING []WITS OTHER UNITS. : 0 TURN ( 100K STU: 1 (!.T 10000 cfm: 0 GAS OUTLE=TS. : 1. r " IRN ) --100K PTUi 0 ) 10000 cfm: 0 m ar^k s : Replace existing furnace w/gas furnace. Owner-: - _ -__ _. _.. ...-_......._....._._.._._.__._. ____._._._....._._____..-___ _- __-_-_.__.._ FEES I.. TNDA OUANDT type amo,.crrt by date r-ecpt 1. 1500 SW COLE PRMT 25. 00 GEE) 01/14/99 99-312198 CAPD OR 97^23 r7PET 2 1. 25 GEO 01 /14/99 99--31.21.98 r'hone #: (111LE HEATING & COOL_I NG INC 11''420 SW SUMMERCREST DR ! 26. 29 TOTAL_ TIGARD OR 97223 "'One #: 579--2250 001.0135 RF0UTRFD INSPECTIONS __._.. " .s permit is issued sut jest to the regulations contained in the Gas Line Ins p yard Municipal Code, State of Etre. Specialty Codes and all other Heating Unt Tnsp :ppl icable laws. All work will be done in accordance with Final Inspection approved plans. This permit will expire if work is not started _ within 180 days of issuance, or if wore is suspended for sore "�an IN days. ATTENTION: Oregon law requires you to follow rules pted by the Oregon Utility Notification Center, Those rules are `;rth in OAR 952-081-8010 through OAR 952-NI-NN. You say "sin copies of these rules or direct questions to OUNC by railing <, "> By : mer m i tt ee Signa, rr z 4 4 4.4 4 -F++++++++4 4+++++++-q 4-++++++++++++++++•+++++++++++ ++++++++++++++++-r-++++ Call 639--4175 by 7:00 p. m. for• irnspert ians needed tl-r rie):t btcsi.ness clay L++++++++++++++4+++4++++++4.4-J-++++•++++4+++++++++++++++•+ +++++-F++++++++++++++++++ CITY OF TIGARD Mechanical Permit Application Plan Check# 13'1 25 SW HALL BLVD. Commercial and Residential Recd ByDate Recd TIGARD, OR 97223 Date to P.E. (503) 63Q-4171, x304 Date to DST Print or Type Permit#A1ht 9?-00Rq Inromplete or illegible applications will not be accepted called — Name or Developm, led L escription Table 1A Mechanical Code Oty Price Amt Job Street Address suns# A Permit Fee M10.00 Address ! '�7 C) r�C�) � � 1) Furnace to 100,000 BTU Including ducts&vents 6.00 Bldg# CRY/state zip 2) Furnace 100,000 BTU+ _ including ducts&vents 7.50 Name(or name siness), 3) Floor Furnace Owner / Includingvent 6.00 M ing Address 4) Suspended heater,wall heater O or floor mounted heater 6.00 5) Vent not Included in appliance permit (CRY/State, p / Phon?`y 3.00 y^ ? CHECK ALL 'Boiler Heat Air Name(or n of 6usines THAT APPLY: or Pump Cond Qty Price Amt Com •• Occupant Melling Address 6)<3 P;absorb unit to _ 6.00 7)3-15 HP;abscrb unit CRY/State Zip Phone 100k to 500k B-,'U 11.00 8)15-30 HP absorb unit.5-1 mil BTU 15.00 Contractor Name 9)30-50 HP;absorb KI-411 ! &I ( !'Zs£• J unit 1-1.75 mil BTU 22.50 Prior to permit Mailing Address 10)>50HP;absorb unit issuance,a copy l 0 C � >1.75 mil BTU 37.50 of all licenses ny/ ate ip Ph9ne 11)Air handling unit to 10,000 CFM are required if t1'' G - 4.50 expired in COT Oregon c Cont.Bo lc.# � Exp. ale 12)Air handling unit 10,000 CFM+ database %_ C _ 7.50 Architect Name 1 13)Non-portable evaporate cooler 4.50 or Mailing Address — 14)Vent fan connected to a sir.,a dud _ 3.00 15)Ventilation system not Included in Engineer Cny/State zip I Phone - appliance pemit 4.50 _ 1 16)Hood served by mechanical exhaust Desrribe work to be done: — 4.50 17)Domestic incinerators New O Repair O Replace with like kind: Yes O No O 7.50 ResidentialA Commercial O 18)Commercial or Industrial type incinerator _ 30.00 Additional information or description of work: 19)Repair units _ 4.50 20)Wood stove _ 450 A 21)Clothes dryer,etc. __ _ 4.50 Type of fuel: oil O natural gas LPG O electric O 22)Other units _ 4,50---- 1 hereby acknowledge that I have read this application,that the information 23)Gas piping one to four outlets given is rorred,that I am the owner or authorized agent of _ _ 2.00 W the that lans submitted are In compliance with Oregon State laws 24)More than 4-per outlet(each) S�na er/Agent Date _ Minimum Permit Fee$26.00 SUBTOTAL J ' — 2 i 5%SURCHARGE P iso Name Phone PLAN REVIEW 25%OF SUBTOTAL ' R�ulrad for ALL commercial rmits nnl L �Li'�SG�— TOTAL 'State Contractor Boiler Certification required —Residential A/C requires site plan showing placement of unit I Umechperm.doc rev 07/20/98