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11605 SW LLJRLCREST DRIVE
CITYOF TIFARD
((;ffYOF TWARD) MASTER PERMIT
COMMUNITY DEVELOPMENT DEPARTME141 ONGON PERMIT
13125W]VW1 Bled. P.O.Bru 23397,T4ptd,Oregm 9722' 8.'19-4,15
t I L i i DATE ISSUED: 08/12/91
SITE ADDRESS. . . : 11605 SW BUIRLCREST 17)R PARCEL: 1 S 13 4 CA J4 0 0
SUBDIVISION. . . . : BURLWOOD NO. 2 ZONING: R-4. 5
BLOCI... . . . . . . . . . : LOT. . . . . . . . . . . .. . . 18
BUILDING
REISSUiZ: DWELLING UNITS: 1 BASEMENT. . . . . . . . :0 s
CLASS JF WORK. :ADD BEDRMS: 1 BATHq: 1 GARAGE. . . . . . . . . . .0 Sf
TYPE OF USE. . . :SF FLOOR REQUIRED SETBACKS-
IYF.'T- OF CONST. :5N FIRST. . . . : 14a sf LEFT. . :7 ft RIGHT. :0 ft
OCC.UPANCY GRP. - R3 SECOND. . . :0 s:f FRONT. :0 Ft REAR. . :42" V tr
SIORIES. . . . . . . : 1 TH I RD. . . . :0 S f
H..:"IGHT. . . . . . . . : 1 Tj ft TOTAL. -- ----; 140 s f SMOKE DETECTORS. ;Y
1-4-MIR LOAD. . . . .40 psf VALUE. . . . . is: 3000 PARKING SPACES. . :0
Remarks : ADDITION r 13 1 /2 FEET
PLUMBING -------- ------------------------------
S-INKS. . . . . . . . . . :0 FLOOR DRAINS. . :0 BACKFLOW PREVNTRS. . :0
LAVATORIES. . . . . : 1 WATER HEATERS. . .. :0 TRAPS. . . . . . . . . . . . . . :0
TUB/SHOWERS. . . . : 1 LAUNDRY TRAYS. . . .0 CATCH BASING. . . . . . . :0
WATER CLOSET S. . : 1 SEWER LINE (ft ) . :O GREASE TRAPS. . , . . . . :0
DISHWASHERS. . . . :0 WATER LINE (ft ) . :0 OTHER FIXTURES. . . . . .0
GARBAGE DI5P. . . :0 RAIN DRAIN (ft ) . -O
WASHING MACH. . . :0 5F RAIN DRAINS. . :LA
------------- MECHANICAL FEES
FUEL TYPES------------- - UN J T I-ATRS. . :0 tyre amount toy date t-erpt
VENTS . . . . . :0 SPIRT $ 38. 50 JLH 08/12/91 -
MAX INPUT:0 BTU QE14T FANS. . - 1 BPLC $ 25. 03 JLH 08/06/91 2'1609 ,'
FURN < 100K . . :0 HOODS. . . . . . :0 B5PC f 1 . 93 JLH 08;'11'/91
FURN . . :0 WOODSTOVES. :0 MPRT $ 13. 00 J L H 08/ 121'/')I
FLOOR FURN. . . . -0 CLO DRYERS. : 0 M5PC $ 0. 65 JLH 08/12/91
ROIL/CMP ( 3144:0 OTHER UNITS:O P,,r,R T $ 221. T-10 it-14 08/12/91
GAS OUTLETS:0 P5PC $ 1. 13 JLH 08/12/91
Owner,:
ROGER SWAREN
1313 63RD N E
JALEM OR 97301
Phone #:
OWNER
Pt one #:
Rey #.
$ 10,2. 74 TOTP-
This pereit is issued subject to the regulations contained in the REQUIRED INSPECTIONS
Tigard Municipal Code, State of Dre. Specialty Codes and all other Foot/ftit.md Insp Gyp Board Insp
applicable laws. All work will be done it accordance with ?pprovpd Post/Beam Stv-uct Rain drain Insp
plans. This permit will expire if work is not startea wijhjn 180 Post/Beam Meehan ileuhaniesl Final
days of issuance, or if work is:ljsp Bort than 180 days. PLM/Underfloor Plumb Finalc--
Mehanical Insp Building Final
i ,ev-mittee Siynatii . Plumb iup Out Er-usion contt-01
Framing Insp
Issued By : Insulation Insp
L.aI I f o i n s ppet on - 6t1)-4175
�
CITY OF T1'lJARD lsiI"�=z�3��d PLNCK/RECT #
PERMIT # &5t
(','0MMUNi1Y DEVELOPMENT DI: ARTM ?NT Tigard,Oregon 97J - G /
(503)639-4171 DATE ISSUED
JOB ADDRESS: //�D�v �� 1 ��c� �u q d�i>��� . �a� TAX MAN/LOT
SUB: LOT: LAND USE:
VALUATION:
OWNER SPECIAL NOTES
NA.". ; �,l�,��-,, �3, ��rren — _ REISSUE OF: —
ADDREss�:�— ` 1-3 CC3r� ll�. , ___ _ I AST REISSUE:
q-) -)ell FLOOD PLAIN/
PHONE:I_ , �^4t ' / 3.5 SENSITIVE LAND: —
CONTRACTOR IPPi\OVALS REQUIRED
NAME: C'61-1 E/c FLANNING:
ADDRI SS: ENGINEERING:
FIRE DEPT: _
PHONE: _--� — �-�-- _ OTHER:
CONTR. BOARD #: EXP DATE: _
ITEMS RrDUUIRED
SUBCONTRACTORS: PLUMB: — LIST/SUBCONTRACTORS:
MECH: _,--_.-�- _-__-- BUS TAX: _--!
ARCH ENI:i_NEER CALCULATIONS:
NAME: _ _ TRUSS DETAILS: _—
ADDRESS: --_-_-,__-� OTHER: — --
PHONE: _-------- -- ------ --------- ---
PROPOSED BLDG. USE:
COMMENTS: —.__ -- — _ — --- ----_— ---
APPLICAN,f SIGNATURE
Received By: __ Date Received:
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
h'15 -u ILI 10-432 00 Building Permit. Fees L' 5v _:,y �1?0
10-431 00 Plumbing Permit Fees a2.3-V
10-431 01 Mechanical Permit Fees , �:; ��_ r ,L; "')
10 230 01 State Building Tax (5%) J " L 3,;'/
Building i• .� ,✓
Plumbing / ,x
Mechanical G s
10-433 00 Plans Check Fee -2 s. v 3 X03
Building
Plumbing
Mechanical
10-230 06 Lire
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF fees
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-443-03 Office TIF Fees
25-448-01 Residential Traffic Fees
25-448--05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC)
24-445-01 Water Quality (Fee in lieu of)
2.4-445-02 Water Quantity (Fee in lieu of)
TOTAL 14,2 7
i
nm/3587P.WPF -
CITY OF TIGARD
13125 SW HALL BLVD.
PLUMBING I'I::IZM ["T P. O. BOX 23397
Applicants must Fwld Oregon Registration to conduct a plumbing T I GARD, OR 97223
business or must tx property owner/operator not hiring outside help. 5�3)63 9-4175
Name of l7evekhpnheM — --- -- -__ Plumbing --
Permit No.
Addre" Dlev"*on
ORS 614-21$10 OUAN. PRICE- AMT.
.Job Tax lot- --- Map No.. —
Address
—___ - FIXTURES
1101 Block Sutxlivlskxh
Sir* 7-50
---- N awn scK r►err�e-To buss iess Lavatory -- — 7.50
Tub«Tub/howes Comb. t 7.50 _ 311
TdaiTwig�ss --- Shpw.e,Only -- 7.50
Owner C*-/Slate -_— -7p - Waterf loset __-- j 750 1
Dishwasher 7.50
- ------- Phone Garbage Disposal 7.50 !-
-- Mame — WashingMachne -- -- -- /.50
Floor Drain 7.50 — -
6daiwg Address __-__PhoneWater Neater- -- ---- 7.50-- - --
--
Occupant — Laundry Room Tray 7.50
P ;�y/SLite
Urinal 7.50
—-- Name — Otfw Fixtures(Specify) - 7.50
— — 7.50
1.Ta 4-V Address - — Pt>one ---- --- —-- 7.50 -
__ ------
Contractor City/Sate_—-- — ZlP 7.50
MISCELLANEOUS _
— — City:jus.T ex No. Sewer 1 st 100- 30.00
State s.�oerdNo- tete kxZr iers�usLic.No
Sewer-ea.Addit.too 1 s.00
(Residential) Water Servioe IM"00' MOO
I rrereW acknowledge that I have reed this application.C'M the Information Water Service ea_Addams' 15.00
given is correct.that I am regixieted with the State OL*W a Rosnd.and also Storm 6 Rain Drain 1 st.100' 90.00
have a State Ptrrntft license that the nutrd rs given are correct that at ---- -
pkwnbwhg work will be done in ecc«denrb with applicable provisions of Oro- Stomp 6 P tin Drain Addit.100' — 15.00
gon Revised Stables Chapters 447 and 693 and applicaNe oxxsas and that Mobile Hate Space 25.00
rx+help will be ernnk►yed unless licansed under ORS 693 (t exempt L -
State reglstratio a.please give reason be". Back now Pnreenbon
140MEOWNUFIS-t het"owtify that i am the owner of the property de- Ddvi or Anti PulkRion Device ----750
scribed Mx".N w4dcth locetkxt t propose so make a pkxnbkx installation for Any Trap or Waste Nd
my own use and this property Is not being constnrcfsd ler sale.lease or rent Crxrhected b a F Kb" 7.50
Ca"Basin --�- - 7.50
insp.d Ede.Pkrnbing - 40.00 Per f-it.
Specially Reque0ed kuph�lons 40.00 Per fk
Aber.&Pl rnbirrt within ------
an F-x%*v f3ldg 15.00 min-
AUTHORIZFD SIGNATURE Oa1e New BWg.or Build.Addition 25.00 min.
Oescxibe work new❑ dd
sitio n o afteretion❑- repalf El � t'Su-tifid u l
le rg .5.0 I
t4 ae dabs residerriial j_] --_non-teskieL%a�_ - —
E-x}stkV use of
bLM*V or propo(tY-------_-- -- ---- -_ $25.00 minimum SUB--TOTAL
Pro906ed U"of 5% SURCMRGE
2.5% PLAN RFVIEW
I40MU ---- --
TThis Per nM beoonw a r*A and void 11 work or oonatrvolkhn w d hotttad M rid corn 'TOTAL 1 `
mx,oad wWhln 110 iayapo tr oor,ertrctlorn«work{°M�havlad«abrndoned fcx --
a ptrokxl of 190 6"at any 6nw Wier work M oonv~%ced.
111MC1AL 00WATK)W
Gate, lesued - t'y -- ----
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�Y�� Sr,�arevl, �Ren.�al CPhol�e in Sa-�en� 3F�1- ��{3S"�
1 I�oS 5.c�J, 8,,cr�cre5�' ✓.� ���� q�:«3 (&u- block k
Add a neuv BaAreom
ar Add 4o maser 8eclroom
W C ST E L E vwri od
f,c l5r :_ 41P
n•� k _ - '� d Ra��Ks
—
FAc e- j C K iS-rW G bED Rom
� K4 Walls I �
Remove fhis bMr1't cJa(1
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I j �-e n�a+qe M a s�Pr 6 ed rraOpl I
I4---rQW I-.odrodo► w fh"A -(hese d te /fines(Arfo- odd
W under layne#4 i I v,;I f ba Oke ne j elofemom,
2 7'4 G Dec r rig
4 x(� Floor ro,5f
�54�.n�Nc fioo{rn9
q X 15, t'o ` a[1Cit�lOr1 �o bct l�d�x
7
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4eteaa-4e Idsu1ULa� , irn C pi itK9t a*4 Q1( A►ee FK4rtor Og1�5.'�`
�,i J�pou rn l f hoa rd i h be4reem c lofr s, of (.?ePecof jypsuMt to b-tMOOOM,
y� x �; • ha►�b�ar�1 s�'cliny over 8ur�c�tn��aPe�� or, exfe►^tor c�a.�ls.
—FE - n operty .Fine
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PROPERTY LINE
CITY A TIGARD ME(;!-IAN I CCL
DEVELOPMENT SERVICES FIERMIT
13125 SW Hal!Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : MEC-37-004E
DATE ISSUED: 02/218,197
PARCEL. 1 91.s4 C(1--04500
',T[". ADDPFS'�3. . , 11605 rW SUPt_CPE E'l FJ4
JBD i V ISI ON. . . . : SURI_WCIOD NO. ZONING: R- 4. 5
A aS Or' 1,ORI'. . :Al...T f-l_OOR ['URN. . . . : 0 EVAP COO1 ER- S: 0
YPE OF USE. . . . .BF UNIT HEATERS. . : 0 VENT FANS. . . : 12)
(7,CUPANCY GRP, . :R3 VENTS W/O —APPL.: 0 VI`:NT' SYSTEMS: 0
-rORIf"s. . . . . . . . BOILERS/COMPRESSORS HOODS. . . . . . . : 0
'JEL. TYPES-___....._..... .___......._ _. 0-.7 III''. . . . : 0 DOMES. INCTN: 0
GAS/ / / 3-- 15 HP. . . . : 0 C:OMML. I NC I N: 0
1-1X INPUT. 0 BTU 15- 7,0 VIP. 0 IRE PA I R UNIT!:): 0
IRE DAMPERS?. . n 30-50 HP. . . . : 0 WOODSTOVES. . : 0
.;QS f"'R[_:Sal IRF_ . . . : `i0+ HF'. . .. . : 0 CLO DI�YERri. . : 0
'40. OF AIR HANDLING UNITS OTHER I►NITS. : I
"1.JRhl ! t viov PTU: 0 (-- 10000 cfm : 0 OnS OUTI_ETS. : 1
"I J RN '1 =100K RTU- 0 > 10000 c f m: 0
L'' ?0l i1'1!7 : Tro;1,AI l gasi fivpplaticE 24,nd Q,pi ] ilii?
llwnet-. FEE _.__.._..._.__..._._
]OEP 0WARE~N I;ype amaI-rnt by date r,ec:',p'
,.Goo SW 13URLCREST PRMT $ 25. 00 JSD 02/213/97 97--L,91 :
5171171' $ 1.. P5 JSD 07'/28/97 '37 29112;
".GAPD OR 97223
lone #:
1LE MECHAN]CSI INC
9 PDX 7176
f AVERTON OR 97LA07
lane # : i",�f0 +14 ', t '(',.• :-'S TOTA1-.
Pfr,91 14
REDU I RE:D I NSPECT I ON5
is perart is issued Subject to the regulations contained in the Mechanical Tnsp
Tigard Municipal Coda, State of Ore. Specialty Codes and all other Find Tnspect ion
applicable laws. All wank will be done in accordance with _
+pproved plans. This permit will expire :f work is not started
wthln 18P days of issuance, or if work is vispended for more
in 18e days.
i 1. 13 AJ_Lluw�_
Cell for• inspccrt ion 6 ?9 417°=,
Plan Check# _
Cl NOF TIGARD Mechanical Permit Application Recd By-_
13125 SW HALL BLVD. Commercial and Residential Date Recd -
TIGARD, OR 97223 Date to P E
(503) 639-4171, x304 Date to DST
Print or Type Fermit# ,r1E Cq-7 0t')
Incomplete or illegible applications will not be accepted called_ ` t
Name of UtiveiopmentiProtect Description
Table to Mechanical Code ory PRICE Ah1T
Job Street Address Suwres A) Permit Fee -0- 0- 10.00
Address I L' -'A') &
Bldgs coyistate Zip B) Supplemental Permit 300
Name for name of business) 1 1 Furnace to 100 000 BTiJ i 600 —
Owner incl ducts 3 vents
Maim dress 2) Furnace 100,000 BTU+ a
—750
cincl uts&
City/Stale 1 Zip none 3 I FlootlFurnaceents – 600
r��� - 3 _ incl.vent _
Naithilt for name of ousinr...f 4 1 Suspended heater gall h later - 6 00
or Floor mounted heater
Occupant Maihng Address 5) Vent not incl.in 300
appliance permit
CrtymState zi, Phone 6.) Boiler or comp,heat pump,air Gond 6,00
_ to 3 HP,absorp unit to t00K BTU
Name 7) Boiler or comp,heat pump,air cond. 1100
1 O fm r�'E rn� 3-15 HP absorp unit to 500K BT'J_
Contractor Melling Address B) Boder or comp,heat pump,air cond 1500 T
L.i Itr, 15.30 HP, absorp unit 5-1 and BTU
(Prior to City/State Zip Phone 9) Boder or comp,heat pump,air cond. 22.50
issuance A copy C1 (�' r?=700 k, 'r (,.. 30-50 HP:absorp unit 1-1 75 mil BTU _
of all licenses are Oregon Const Cont.Boats Lic s Exp 0 a ) 10.) Boder or romp,heat pump,air cond. � 37.50
required if 1) I'I Q ►.h 7 >50 HP,absorp Unit 1 75 mil BTU _
expired in C O T COT Business Tax or Me"a ESip ae �; 11 ) Air handling unix :m 4 50
data base) t; c" 1 ' 10,000 CFM__ _
Architect Name 12? Air handling unit 750
10.000 CTM+
or Meiling Address 13) Non portable 450
evaporate cooler
Engineer crtWstafe Z;p Pnone 14) Vent fan connected 3.00
to a single duct _
Descnbe work New O Addition O Alteration 4 Repair O 15 I Ventilation system not 4 50
to be done Residential 0 Non-residential O included in appliance permit
Additional Descnpoon of work 16) Hood served by mechanical exhaust 4.50
I
Y t1S I 1 (2e` -k GC;,� (,n� 17) Domestic incinerators — _ 750
Existing use of 1 181 Commercial or industnaltype 3000
building or property incinerator
191, Repair units 450
Proposed use of 20) Woodstove 450
building or property —
_ 21) Clothes dryer.etc 450
Type of fuel-oil C natural gas,Om LPG O electric O 22) Other units 4 50 U S
I hereby acknowledge that I have read this application that the 23) Gas piping one to four outlets 200
information givens correct that I am the owner or authonzed agent of
the owner,that plans submitted are in compliance with Oregon State 24) More than 4-per outlet (each) 50
laws
ign ture of OwnerlAgent Date QTY.SUBTOTAL
o- ------ SOW U �I LL— _
Contact Person Name Phone 5416 SURCHARGE
L
PLAN REVIEW 250,16 OF SUBTOTAL
TOTAL
6 7
mdstlmechpmt doc (rev 7;96) -Minimum permit fee is$25+5%surcharge
CITY OF TIGARD BUILDING INSPECTION NOTICE
Fr Inspection Line: 639-4175 Business Phone: 639.4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb
Post/Beam Mach. Shear/Sheath Framing ech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. dough-in Gyp. Bd. -Bldg.
`'� ✓ A r/Sdwlk
San. Sewer Gas Line NP Reins.
Other: _ we�:J-Lai
Date: 31--V7 u A. 03 .M.._r__ Entry:
i
Address: —�/ � G� C-- A LL A
Tenant: Ste:_ MST:
l� 1, —�l '-fI tiara MECBLIPz' J
/Own: MEC:
PLM: —
ELC: _THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: .
Inspector: -- -- __— Date: ._
APPROVED _._DISAPPROVED/CALL FOR REINSP. CF CO