11900 SW CARMEN STREET co
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11900 SW Carmen Street
CITY OF TIOARD BUILDING INSPECTION DIVISION
24-Hour Inspeair n Line: 639-4175 Business Line: 539-4171 MST — —_
BLIP
Date Requested //�a? CJ/ AM--_– -PM - _- BLD
-ocai.-)n Sec) C/9/lfy-!5� sr SuiteMEC
_ -----��— ---
Contact Person ph PLM
Contractor _ Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall -- --- _-- - -
Footing Access ELR -�
Foundation FPS
Fig Drain — ---
Crawl Drain Inspection Notes: �- SuN
Slab –
Post&Beam
--- --- ---._ ----- SIT
Ext Sheath/Shear
Int Sheath/Shear --
Framing
Insulation
Drywall Nailing
Firewall •—�
Fire Sprinkler k4,
Fire Alarm
Susp'd Ceiling _ �
Roof
Misc:
Final �--- --- — ---------
PASS PART FAI0
PLUMBING - --
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer -- --
Rain Drains
Finsl - - - -
PASS PART FAIT_
Post& Beam -- -_
Rough In
Gas Line �Z� -- -
Smoke Dampers
Final
PASS PART FAIL_
ELECTRICAL~ -
Service
Rough In - - — -- — —
UG/Slab
Low Voltage --- —
Fire Alarm
Final --- _— —_
PASS PART FAIL
SITE `
Backfill/Grading -- -------- --. _
Sanitary Sewer
Storm Drain I ]F einspertion 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 _!'_r ��'� `-` Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
1,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-hour Inspection i-71oe: 639-4175 Business Line: 639-4171 --
c=
OUP
Date Requested "" AM PM _ _-- BLD _
Location /� `/ < < ��1� n =t7 Suite _ MEC ''"2 i c"?
Contact Person I Ph � _ � PLM
14
Contractor Ph SWR
BUILDING Tenant/Owner _ ELC _
Retaining Wall v ELR _
Footing Access: — -
i-oundalion FPS
Fig Drain ---��-----`l_-�
Crawl Drain Inspection Notes SGN
Slab -- - --r.__- - _ -------- — -- SIT
Post&Beam --------
Ext Sheath/Shear
Int Sheath/Shear ---- ----------
rraming
Insulation ---------- ------ --_..____
Drywall Nailing
Firewall --_ __._--.------ -_
Fire Sprinkler
Fire Alarm -
Susp'd Ceiling
Roof
Misc:
----------------
Finai
PASS PART FAIL - ----_- _- - ---�_-_
PLUMBING
Post& Ream - -
Under Slab
Top Out - - ---
Water Service
Sanitary Sewer -- - -- - - - -
Rain Drains
Final - - -- -- --
PASS PART FAIL
MECHANICAL
Post& Beam - - - --- -
Rough In
Gas Line -- -
aks Dampers
td
�AS3 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$ repaired before next inspect on Ny at I lall t I12f; SW I loll t4hd(',
Catch Basin
Fire Supply Line ( ]Please call far reinspection RE:_ __- I I Unable to m�r)rri n;,
ADA
Approach/Sidew-N Date 1 _ )A 1-
Other Inspector - Ext
Final
PASS PART FAIL DO NOT REMOVE this inspectiori record frons the jot) site.
1
CITY OF
TIG ^ R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00407
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/14/01
PARCEL: 2S103BD-02600
SITE ADDRESS: 11900 SW CARMEN ST
SUBDIVISION: CARMEN PARK ZONING: R-4.5
BLOCK: LOT: 005 .;URISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: 5F UNIT HEATERS: VENT FANS:
OCCUFANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES _ 0 3 HP: DOMES. INCIN-
LPG 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP:
REPAIR UNIT:
FIRE DAMPERS?: 30 - 50 HP:
OD :
GAS PRESSURE: 50+ HQ: CLU DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS C
OTHER UNITS1
FURN >=100K BTU: Y <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:: 1
Remarks: Install gas Heat ii-Glo fire place
Owner: _ FEES
MADDOX, CLIFFORD L AND Type By Date Amount Receipt
CAROLYN J PRMT CTR 11/14/01 $72.50 272001000E
11900 SW CARMEN ST 5PCT CTR 11/14/01 $5.80 2720010000
TIGARD, OR 97223
Phone: Total $78.30
Contractor:
TRI TECH HEATING
660314E 137TH AVE
VANCOUVER, WA 98682 REQUIRED INSPECTIONS
Gas Line Insp
Phone:360-891-2002 Mechanical Insp
Reg #:LIC 101873 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct qu tions O C t y Celli
tr;ni1?.iR-q1 77�
Issue By: , Permittee 'iignature'
Call (5031 639-4175 by 7:00 P.M. for inspections needed t6s,next business d4.)
Mechanical Permit Application
"Datc, ived: I t / ® Permit no. Od yp'
City of Tigard Project/appl.no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd,Tigard,OR Date issued: By: Receiptno.:
Phone: (503) 619-4171 — —_
Fax: (503)598-1960 Case file no.: Payment type:
Ladd use approval: _ Building permit no,:
61 W
1
SIV 1 &2 family dwelling or accessory U Commercial/indu.su tit] U Multi-family U Tenant improvement
U New construction V Addition/alteration/replacement U Other:."
INFORMATIONVALUATION
Job address: I 1LY) L ('fY j��, — Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite uo,; value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivision: "See checklist for important application information and
Project name: r - jurisdiction's fee schedule for residential permit fee.
City/county: i r 7.IP: _ t i
Mscriptiorl and
�,location.of'work on p •mis�s�� t t
2
HL�.()_'I�Pt �t_�1 I tr.(ta.) I trial
Est.date of completion/inspection: —17De%triprion Oty. Res.only Res.only
Tenant improvement or change of use:
Is existing space heated or conditioned?U Yes U No Air handling unit CFM _
space insulate(,'?U Yes ❑No it conditioning(site plan required
Is existing _
•P Alteration o existing AC system _
of er compressors
Business name: - r• - State boiler permit no,:
HP Tons__BTU/Il _
Address: (�" l' 1 tA Fire/smoke dampers/duct smo a electors
City: ► V-t.f State:\A f 'LIP: ;,� cat pump(site plan required)
Phon••: >.. Fax: r' Email: nsto repaccfurnac urner )
Including ductwork/vent liner U Yes U No
CCB no.: (I/8`)z I nsta I Urep I ac re I ocateeaters-suspen7cd,_
City/metro lic.no.: wall,or floor mounted
Name(please print): }' '(f t_. ( (� 1 cot for a lance nt err than furnace
e gest on:
Absorption units_ _ BTU/H
r'h0llers IIP
7Phonc.
nv ronmenta ex ust an vent ation:
State: ZIP: Appliance vent
Fax: E-mail: Dryerexhoust
int s,Type res.kitc cn/hazmal —
�t1+1N hood fire suppression system
Nante: Exhaust fan with single duct(bath fans)
Mailing address: --_ _ _ _ __ - x taust system a ort from rear n or AC
City: State: ZIP: -ue p p ng andistribution(up to outlets)
Type: LPG NO Oil
Phone: Fax F;-mail.
Fuel pipingeach additional itiona over 4 outlets
rocesr;piping(sc emaucrequire )
Number of outlets _
rNic: ter st app nce or equ pmt ent:—
ress: _ _ _ lcorativcfireplacc: _ _ State: ZIP: _ � nsert-type
Phone: Fax: E-mail: o stov pe etstovc —
y t Other:
Applii a:ri's signature: Date: 1
N,x all jurisdiction,accept credit rants,please can jurisdiction Im man Infomraurm Pertnit fee.....................$
U Visa U MasterCard Notice:This permit application Minimum fee................$ �.
Credit card number: L--1expires if a permit is not obtained plan review(at — %) $
- within ISO days after it has been
F"pin' State surcharge(89F) $
Nam
--- Naof cardholder a,shown on c acreted as complete.it card p p i7 G•
S TOTAL .......................$ _. ..-�.G-
---
Cardholder signature Amount 1404611(6001170M)
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUA_TION:_ FEE: Description: _ Price Total
$ -� Minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) Amt
1.00 to$5,000.00
$5,001.00 to$10,000.00 $72.50 for the first$5,000,00 and 1) FUmacR to 100,000 vents
$1.52 for each additional$100.00 or Including ducts 0 vents 14.00
fraction thereof,to and including 2) F including
100,000 07U+
$10,000.00. includin ducts&ven�s 17.40
$10,001.00 to$25,000.00 $140.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additiunal$100.00 or includin ent 14.00
fraction thereof,to and Including 4) Suspended heater,wall heater
$251000.00, or floor mounted heater 14.00
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional$100.00 or 6.80
fraction thereof,to and Including 6) Repair units
12.15
$50,000.00,
-
$50,001.00 and up $742.00 for the first$.50,000.00 and Check all that apply: Boller Heat Alr
$1.20 for each additional$100.00 orctii For items 7-11,see or Pump Cond
fraction thereof. footnotes below. Comp"
-- 7)<3HP;absorb unit
- to 100K BTU 14.00
ASSUMED VALUATIONS PER APPLIANCE: _ _ 8)3-15 HP;absorb
Value Total unit 100k to 500k BTU 25.60
Description: Q Ea Amount 9)15-30 HP;absorb
Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU _ 35.00
ducts&vents _ 10)30-50 HP;absorb
Furnace>100,000 BTU including 1,170 unit 1-1.15 mil BTU 52.20
ducts&vents 11)>50HP:absorb
Floor furnace Including vent 955 unit>1.75 mil BTU 1 87.20
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not Included In applicance 445 13)Air handling unit 10,000 CFM+
±rmit 1 17.20
Repair units 80514)Non-portable evaporate cooler
<3 hp;absorb,unit, 955 _ 10.00
to 100k BTU 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 6.80 -
101k to 500k BTU -- 16)Ventilation system not included in
15-30 hp;absorb.unit,501k to 1 2,310 appliance permit 10.00
mil.BTU -- - 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 _ 10.00
1-1.75 mil.BTU - 18)Dcmestic Incinerators
>50 hp;absorb.unit, 5,725 17,40_
>1.75 mil.BTU -- 19)Commercial or industrial type Incinerator
Air handling unit to 10.000 cfm 658 89.95
Air handlin unit>10,000 cfrn 1,170 20)Other units,including wood stoves
Non-portable evaporate cooler656 10.00
Vent fan connected to a single duct 446 21)Gas piping one to four outlets
Vent system not Included in 656 - 5.40
appliance permit 22)More than 4-per outlet(each)
Hood served by machanical exhaual 656 1.00_
Domestic Incinerator _ 1 170 Minimum Permit Fee$72.50 SUBTOTAL: $
Commercial or industrial Incinerator 4,590 _
Other unit,Including wood stoves, 656 8%State Surcharge $
Inserts,etc. _
Gas piping 1-4 outlets _ 380 25%Plan Review Fee(of subtotal) $
Each additional outlet 63 Required for ALL commercial permits only
TOTAL COMMERCIAL s TOTAL RESIDENTIAL PERMIT FEE: $
_VALUATION_ ---
��_ Qther Insnectloas and Fees:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72 50 per hour
2 Inspections for which no fee is specifically indicated (minim!m charge-half hour)
$72 50 per hour
3 Additional plan review required by changes,additlons or revisions to plans(minimum
charge-one-half hour)$72 5o per how
'3tate Contractor Boller Certification required for units>200k BTU.
"Residential AIC requires site plan showing placement of unit.
I:kfsts\forms\mech-fees.doc 10/11/00
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
Date Requested ��12PL6 AM PM BLD
I 7_Location 0- 4✓ Suite ('M C f y,Luh
,,,,,, ,
� 7
Contact Person ��I,t � Ph (, .�,U1 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining% all ELR
Footing Access:
Foundation 2 FPS
Ftg Drain 4� SGN
Crawl Drain Inspection Nbtef. - ------- --- - -- -
Slab -- ,—�_.- SIT
Post& Beam -
Ext She6th/Shear
Int Sheath/Shear
Framing _
Insulation
Drywall Nailing —
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc - — --- -- — — —
Final
PASS PART FAIL ----- -- — — --
PLUMBING
Post 8 Beam ------- - ------- -- ____.—�—.____—_�_.
Under Slab
,t l op Out — —-- - --
�. Water Service
Sanitary Sewer ----_----- -- -- --- - ---- -- ----------
Rain Drains
Final
PAS PART FAIL_
�EHANICAL` s-
Rouqh In
(;as Line _-_ -- - ----- -- - -------- ---- . _
Smoke Dampers
P PART FAIL
ELECTRICAL
Service
Rough In __.---_—.—
UG/Slab
Low Voltage ---,
Fire Alarm
Final
PASS PART FAILSITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ _- required be+ore nexi inspection Pay at City Hall, 13125 SW Hall 61vd
Catch Basin
Fire Supply Line ( ]Please call foi reinspection RE: _ — ( ]Unable to inspect nn access
ADA
Approach/Sidewalk ..J C �� Ext
` �/, -IOther _ Date ,J Inspector —
lFinal
[-PASS PART FAIL 0 NO REMOVE this inspection r:cord from the job site.
CITY ®F TIGARD -- hiFrHANICALPERMIT
DEVELOPMEN d SERVICES PERMIT#: MEC2000-00088
133125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 3/20/00
PARCEL: 2S1638D-02600
SITE ADDRESS: 11900 SW CARMEN ST N
`�
SUBDIVISION' CARMEN PARK \ ` � JURISDICTION:NGJRB
BLOCK: _—� LOT: 005 C1� _ _ -
CLASS OF WORK: OTR FLOOR FURN: �=-- EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O ADPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
_ FUEL rYPES 0 - 3 HP: DOMES. INCIN:
IPG -- 3 - 15 HP: COMML. INCIN:
MAX INPUT: B rU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPER'-' : 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 504 HP:
CLO DRYERS:
FURN < 100K BTU: 1 _AIR _HANDLING
UNITS
OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of gas furnace.
Owner: _ FEES
MADDOX, CLIFFORD L AND Type By Date Amount Receipt
CAROLYN J PRM4 DEB A3/20/00 $50.00 0000791
11900 SW CAPMEN ST 5PC2 DEB 3/20/00 $4.00 0000791
TIGARD, OR 97223 — - _—
Phone: —__—
Total $54.00
- - ----
Contractor-
TRI TECH HEATING
6603 NE 137TH AVE
VANCOUVER, WA 98682 REQUIRED INSPECTIONS
Heating Unt Insp
Phon^:360-•891-2002 Final Inspection
Reg #: I IC 101873
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applica''jle laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law
requires you to fallow rules adopted in the Oregon Utility Notification Center. Those rules a-e set forth in OAR
952-001-0010 t')rough OAR 052--001-0080 You may obtain copies of these rules or diract questions to C jNC by
calling (503)24E�91�.9.
Issue �� _ Z><ll�tl1 Permitter.. Signature: ,- 1"•C Z s.s . . I,a, f
Call (503)639-4175 by 7:00 P.M. for inspections needed the next business day
Plan Ch
CITY OF TIGARD RECEIVWchanical Permit Application Recd
13125 SW HALL BLVD. Commercial and Residential Date Recd_ q
TIGARD, OR 97223 MAR 14 70M Date to P.E.
(503) 639-4171, x304 p� Date to DST
COMMUNITY OEVELOWNI print or Type UlhPermit#M[
Incomplete or illegible applications will not be accepted Called _
irael
emo of 0evelopmanuprolect De5crlplion
U 'J 1 TaLle 1A Mechanical Code Q Price Amt
GP' V C h' f , - 16 00
Job Address sulten /) Permit Foe _
Address 1) Furnace to 100,000 BTU
includingduds&vents r ee footnote 1,2 9.65
61dgn cnyrstate Yip 2) Furnace 100,000 BTU+
including ducts&vent$__ sea footnote 1,2 12.00
Name( r name of buslness) 3) Floor Furnace
Owner 0i �'t C ur Including vent _ see footnote 1,2 9.65
MalnngAddross 4) Suspended healer,wall heater
or floor mounted heater see footnnte 1,2 9-65
Z�- /f C E�G� Vent not Included In a )iancerm,t 4.75
eeyfstate zip Phone Check all that apply' 'Boiler Heat Air
"r,q(�v ��i /o�r� C ,_��11 f1 For(toms 6.10,see or Pump Cond Qty Price Amt
Nab(o`rna`m�o 1 hurtlnes►) 1SL footnnto8 1,2 _ Comp
6)<3HP;absorb unit to
100K 13TU 9.65
O(;(:Upant Mae"'s^d'i`e ' 7)33-15 HP absorb unit
100k to 506k BTU 17,65
rnyrstata ��.Z—V- Pnono 6)15-30 HP;absorb
Yunit.5-1 mil BTU _ _ 24.15
Nemo 9)30-50 HP;absorb
Contr:acto unit 1-1.75 mil BTU 3600
/' - -7-Ccit #z 10)>50HN; absorb unit -
Prt,r to pertnl Mulling Addrl-a9 - >1.75 mil BTU 60.15
lssuarcx a copy L 3 � L _ 11 Air handling unit to 10,000 CFM
of all licenses
01 yrstete L hone 1,00
are required If G?I awn14/ 1111-,Ai 12)Alr handling unit 10,000 CF0
expired in COT Oregon Const Gor l board I.Ic n 4P.pe 11.75
database 10/S 73 3) dlJ 13)Non-portable evaporate cooler
Architect "a'l'e -— -—
14)Vent fen connected to a single duct
4.75
or Mulling address
15)Ventilation syslern not included In
_ _ —_a liance ;ennit �� _ 7.00
Engineer rtyfstete Zip Pnonm 16)Hood served by mechanical exhaust
7.OU
Desci- work to be.done 17)Domestic Incinerators �
12.00
New O Re air 0 Roolac a with like kind: Yes 0 No O 1 t))Commercial or industr(,I type inclrierator
48.25
Residential Condnercial0
19)Repair units
Additional Inforrnatio or descrlphun of wo k 8,40
20)Wood stove/gas Mother un(ts/clothe dryer/atc.
7.00
NOTE: For Commercial prol".s only Units over 400 lbs require 21)Gas ploing one to four cutlets l
__structural gas colcs. PG O eleclll
a5 c v 22)See footnote 1
Type of fuel: oll O natural g More than 4-por outlet eac ,75
�
Minimum Permit Fee$60.00 SUBTOTAL f
I'hereby acknowledge that I have read this application,that the information �`— 5%SURCHARGE
given is correct,that I am the owner oI suthorized agent of PLAN REVIEW 25%OF SUBTOTAL
the owner,that plans submitted eru in compliance with Oregon State laws. ^Rehr ulred for ALL commercial permits onl
-- TOTAL
Sl g ure of Oe A fit Date
Other Inspections arrd Foes:
_�� _�_ 1. Inspections outside of normal business hours(minlnum charge-two
Con_ ct Porson Name Phone hours) $50.00 pet hour
2. Inspections for which no fee Is specifically Indicated (ntinimurn
�' _ _ 1�I'-) charge-half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. •State Contractor Boiler Certification required
"Residential A.'C requires site plan showing placement of unit
I.Vnechpenn.doc rev 0214199