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14176 SW BARROWS ROAD BLDG 12 s � V m a` H � O A �J am O (n N c LU 20 a a � ;U N (T N O r D r f,. .a 14176 SW BARROWS ROAD Building 12 CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00372 DATE ISSUED: 7/9/03 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 1S133CC-80123 SITE ADDRESS: 14176 SW BARROWS RD 12-3 SUBDIVISION: SCHOLLS VILLAGE CONDOMINUMS ZONING: R-25 BLOCK: LOT: 12 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R1 VENTS W/O APPL: VEN i SYSTEMS: STORIES: BOILERS/COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: ELE 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: FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: Remarks: Install A(' Owner: FEES BOYERS, NANCY Description Date Amount 14176 SW BARROWS RD. #12-3 $72.50 TIGARD, Permit I cc 7/9/03 $72.50 TIGARD, OR 97007 I I AX 18111,Stale]ax 7/9/03 $5 80 Total $78.30 Phone: 503-529-5093 Contractor: SPECIALTY HEATING & COOLING 1601 SE RIVER RD HILLSBORO,OR 97123 REQUIRED INSI2ECTIONS C)oling Unt Insp Phone: 503-640-3607 Final Inspection Reg#: LIC 66578 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 p!,ins. This permit will expire if work is not started within 180 days of issuance, or if work is suspended f�)r 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-OC 10 through OAR 952-r46-(6699. Joe- You may obtain copies of these rules or direct questions to OUNC by calling (503Issue ArA 0,41Permittee Signature: Call ( 3)639.4175 by 7:00 P.M. for inspections needed the next business day Mechanical Permit Application Datereceived: - i 0�3 Permitno.:6 - -pip City Of Tigard Projecdappl,no.: l?ttpirt.date; City,,j'ng,ud Address: 13123 SW Hall Blvd,Tigard,OR 97223 pate issued; 6y: l i Receiptno.; Phone: (503) 639-4171 Fax: (503) $98 1960 Case file no.. Payment type: is•� Land use approval: Building permit no.: 5 1 &: family dwelling or accessory 13 Commercial/industrial 0 Multi-family 0 Tenant improvement 0 Now -onstruction 0 Addition/atteration/n placement ❑Other _ . JOR SITE JINFOW�IATION Jo> addn u: L LJ owYbt)S (? e _ _413 Indicate equipment quantities in boxes below.Indicate the dollar Bic;.no.. 9uitn nu._ valuer of all mechanical materials,equipment,labor,overhead. Tat mai tax lot/account no.: profit.Value$ _------- Lol: Block: Subdivision: *See checklist for important application information and �Prcleotmune: .jurisdiction's fee schedule for residential permit fee. Cir t/cotlt ty: q.-�1 — ZIP: p v t t ULU Det crlpd an and loe tion of work on premises; t IL 7Ronly Pf'r _ Fre(ea.)Est date ]fcom letion/Inspection: Qty, Res.only Ter sat improvement or change of use: h Is existingspace heated or conditioned?O Yes 0 No Air handitng unit �KM_ P Air conditloNng(silo an roqu — Is existing space insulated7 O Yes Q No I Alteration of existing HVAC oyAtern o ler comptrssora Atas,mess ]ame State boiler permit no.; _ ► HP Tons BTU/" A cess: 0 �r�ti Fire/smo dam uct%mo c detectors C{h! Stnte:�s. ZIP:�t 7 est amp arra p on requt ) --- Pha ae�(�,4 O- o Fax: B_mail: meta rep rnac utner / Including ductwork/vont liner 0 Yes Cl No CC 1 n0.: Install/replace/relocate heaters-Auspen�i ctT, Cltl lu►nu)HU.nu.: _ wall,or floor mounted Nar to(pit lame punt): r�(�Ls�.+ i I f w Vent for as IianCe other than tlutrace . g tan 1 1 Absorpt3anunita__. BTtI/Ft Nat 1t, Chillers _ HP -- - Con ,rressor% tip Adt Ie9s: _-- �rotammtal exhattO alit vrn tat... Clt1 state: 2W! —_ -Appliance vont Phu le. Fru: &mail: btycrex aunt _ -- — _-- ■ 1 s.Type ros.kitchen/hatmaI hood fire suppression system i 7 Q a j Exhaust ran with single duct(Bath fans) ImS a Idrt ss: Exhausi system a art from zeatin or C rc piping a ora up to outlets) State: T LPO NQ oilYI� --E-mail: Fite fin each tonal over out ets ess p (schematic requi ) Numberofoutlets Nan app ace or'equ?ipmmt ..��-- --- tesa: _ _ Mcbrativefirepince City State: 27P: neem-type - -- -- tovelve ttseovc Me tc: rax: U-mull: Other _AU Iicant s signature: - Date: Nan c (Pr at): h nl.i-• j« Na aU jurNdu long aceap endf,cords,pteaae call lurtrtictlon for mom lalbrrnnoa. Permit fco.....................S Notice:This permit application Minimum fee................$ d Vis, ic MaataCard expires if s permit Is not obtained Plan review(at _ %) $ _ Crodlt ""�" -- within 180 days after it has been � - --er State harge(g�).... nn accepted as complete. TOTAL $ 3,- 4eme :7 older a•�dcomcar'- P •P -- -- Cadholder sisnamn -- /•�rtamt440AA17(6000000td) d B1LO 8139 EO9 2UT%WaH Rz1etoael8 WOE :BO CO 20 Iter SITE PLAN PL FL Q4,. it�.tD PL PL STREET Specialty Heating & 'Cooling, Inc 9528 S"W Tigard Street Tigard, OR 97223 Phone 503 .620.5643 Fax 503 .598.0718 Hillsboro Phone 503 .640.3607 Fax 503 .681 .0793 E 'd SILO 8BS Ed% AutzQaH RziQ;00d8 � QOE =80 EO~ZO tr '^ CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 639-4175 INSPECTION DIVISION Business Line: (503)639-417' MST BLIP Received _ Date Requested___7_7 0 --_ - AM PM_ BLIP — Location __ Suite�Ld ' 3 _ MEC Contact Person — Ph (___- ..__.) �y 3 G 0 7 PLM Contractor _ Ph( ) —_ SWR _ BUILDING Tenant/Owner - .—._- ELC - — Footin— g --. ELC Foundatio Ftg Drain n Access: � ,/, � � Crawl Drain . 7� �7 ELR Slab Inspection Notes: tlUY SIT l - Post 8 Beam ---_- �- 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 ---- — PLUMBING Post&Beam Under Slab _ Rough-in Water Service . Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: ----- Final - PASS PART FAIL_ v - MECHANICAL _ Post&Beam J Rough-In -- Gas Line Smoke Dampers asi;0TRICAL PART FAIL Service_ Rough-In UG/Slab Low Voltage Fire Alarm Final Reinspection fee of$ required before next ins PASS_ PART FAIL 4 pection. Pay at City Hell, 13125 SW Hall Blvd. SITE [-1 Please cell for reinspection RE —_ Unable to inspect-no access Fi•4 Supply Line ALA Approach/Sidewalk Date - / Inspector - ✓-� ____ Other:_ Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL CITY OF TIGARD BUILDING INSPECTION DIV'!SION MST 24-Hour Inspection Line: 639-4175 Business Line: X39-4171 _— -- // BUP Date Requested. (qv AMS PM BLD Location- /y l � �� S Suite -b� — MEC --- Contact Person ^^ Ph 5-)9-/()(41 1 PLM 1 g- CTS 3 y3 Contractor— Ph ,P O-;�Zi4-j SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: -- - Slab --A- SIT Post&Beam -- --- Ext Sheath/Shear Int Sheath/Shear Framing Insulation / Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling _ Roof Misc._ — Final P RT FAIL •-- --- PLD DIN Under Slab Top Out -- Water Service _ Sanitary Sewer --Rain rains ip PART FAIL ECHANICAL Post&Beam -- -- --------- - --- Rough In Gas Line - - ----- - - ---� —. _ Smoke Dampers Final — -- -- - - --- PASS PART FAIL ELECTRICAL - Service Rough In UG/Slab Low Voltage Fire Alarm Final —� Y PASS PART FAIL SITE Backfill/Grading ----- Sanitary Sewer Storm Drain [ J Reinspection fee of$— —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Calch Basin Fire Supply Line ( J Please call for reinspection RE ( J Unable to inspect-no access ADA Approach/Sidewalk �j r Date 1 Inspector _ Ext - Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business ;nej2 71 BUP Date Requested �� I AM ! _— BLD Location � � k Suite SEC, ' -- Contact Person (2tU 06Lt � L Ph 5_794702- PLM G U�Z-" Contractor GA �`-e "?49`fid- ( _ Ph S��"�D�IynJ;a. SWR _ ELC BUILDING Tenant/Owner - Retaining Well ELR _ Footing Access: ,��^�N ` FPS Foundation Ftg Drain SGN Crawl Drain Inspection Notes Slab -_ _ --- nl r-��(aSt� SIT --- Post&Beam Ext Sheath/Shear -----""— ------- Int Sheath/Shear Framing - ---- - - -. Insulation Drywall Nailing - - ---- Firewall Fire Sprinkler �_._---------—.__. --- - Fire Alarm Susp'd Oiling Roof Misc: - _-- Final PASS P,>RT FAIL - _— — -- ---- PLUMBING Post&Beam Under Slab ---- Top Out Water Service ------- -- Sanitary Sewer Rain Drains -- Final --- -- -- --- PASS PAI?I FAIL --.----___ ECHANIC Post&Beam - --- - --- -----.Roughin - Gas Line Smoke Dampers Fin S$ PART FAIL t4kcTRICAL Servlre — Rough In UG/Slab Low Voltage __- Fire Alarm Final PASS PART FAIL 81TE --------- Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: __ [ ]Unable to Inspect-no access Fire Supply Line ADA G I Approach/Sidewalk pate Inspector yy v EXiJ Other Final PASS PART FAIL- 00 NOT REMOVE this inspection record from the job site. NG INSPECTION DIVISION (: r' CITY OF TIGARD BUILDING ST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171�r.�' B � � __J''�_Date Request d __-_AM PM BLD Location ly -)5 — Suite L:' PLM c�i - �� .� _ _ Contact Person t1 L.c '�'�� -- Ph -� — �--� Contra — Ph SWR � � \ ELC IL Tenant/Owner — Retaining Wall ELR Footing nccess' �- FPS 7 Foundation � 5 Fig Drain - SGN Crawl Drain Inspection Notes: Slab - - SIT Post&Beam Ext Sheath/Shear - ,Int Sheath/Shear ---- Framing - — Insulation Drywall Nailing - — —------ —-- ---------- Firewall — Fire Sprinkler -- Fire Alarm Susp'd Ceiling — -- _—- R oof t S PART FAILMBINl3 - Post&Beam - Under Slab -- - Top Out -_'_- -----Water Service Service -__"-- Sanitary Sewer Rain Drains _ Final p FAIL -------- - — — EC Post&Beam -- Rough In _-- Gas Line -` S oke Dampers _MCTRIMCAL T FAIL Service — Rough in UG/Slab Low Voltage Fire Alarm Final SS PART FAIT_ IT Backfill/Grading -- Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: [ ]Unable to inspect-no access Fire Supply Line ts — DAidewalk Date O -Ex� -z =—f- Inspector PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISIOoff" 24-Hour Inspection Line: 639-4176 Business Line: 639 1 BUP Date Requested I �� AM PM BLD Location /q(-7(a Suite MCC Contact Person a&—U IAC! SI9-IOW "bLi -Ph 5'?`�' PLM Contractord/y� -' �c-�Sou..� Ph �5.;W = SWR _--_ BUILDING Tenant/Owner ELC Retaining Well ELR Footing Access: FPS Foundation Ftg Drain SGN _ Crawl Drain Inspection Notes: Slab SIT _ Post&Beam Ext Sheath/Shear --- Int Sheath/Shear 1 - F� 7 �, c Lam_ Framing - Insulation _ Drywall Nailing Firewall 'nkle ..� d --_- ire Alarm us i ing — — --.. Roof Fin' ART FAIL Post&Basin Under Slab Top Out — Water Service _ Sanitary Sewer Rain Drains -------- Final PASS PART FAIL -- MECHANICAL Post& Beam - - - Rough In Gas Line ---_ - -" Smoke Dampers Final -- PASS PART FAIL ELECTRICAL VSPART(L - -- - AIL WE— Backfill/Grading Sanitary Sewer Storm Drain [ ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 1315 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE: _— [ ]Unable to Inspect-no access Fire Supply Line ADA ( � - Approach/Sidewalk Date `r 1 "' Inspector `� Ext�1 Other - Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 635-4171 BLIP — Date Requested_�� 9 _AM— r PM BLD Location �' I r ��s Suite Z- MEC _- Contact Person 19' I()!r( nw RPh 5 79—,5?0--- PLM Contractor � �''`� �`'J�QK-'� _ Ph o�9�d I n-.c'�JL, SWR BUILDING Tenant/Owner — ELC Retaining Wall ELR -- Footing Access: FPS Foundation Ftg Drain SGN Crawl Drain i Inspection Notes Slab — Post R Ream -_..- -----^--_-" Ext Sheath/Shear ---- - -- Int Sheath/Shear Framing ---- - — _._ -- —_-- -- Insulation Drywall Nailing - ---- - --- - - - -- - -- - Firewall Fire Sprinkler ---- - - - -- - - Fire Alarm Susp'd Ceiling --- Roof mim Final PASS PART FAIL _ _ ----- -- - --- --- - PLUMBING Post&Beam Under Slab - ------- Top Out Water Service Sanitary Sewer Rain Drains __--- Final PASS PART FAIL MECHANICAL Post& BeamRou — Line In Gas Li Gas ne — ----- - Smoke Dampers _ Final —' FAIL EL&CTRICAL SerAce Rough In UG/Slab _— Low Voltage WASS rm ART FAIL — Backfiil/Grading Sanitary Sewer Storm Drain I ]Reinspection fee of$ required beforei spection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin ]Please call for reinspection RE __ Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date�'� C Inspector v � Other -- Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. w co 00 m op m m co m m co co m D C C C C C C C C C C C A -u v -DT A m ONT OTA yO --4 OOo UF O UO LNOWN O b O co fiO M Omy �Db j -1 'o> > NJ] tD m d 'p0 .n ,� ' N Q v O (6Qp1 O N 'D yyO N N m6l O< 7CL O N O fCp 7 n p Q X o O m a v o m �. cn L � N �? W W 7 W W �W N fD � D n o <' m N m jW OD W w W 4.J t0 tD (D p IJ N N f� tp'� 1 tD SOD tD t0 tD tOD f�D OD OBD OD W ^ T. 0 40 G m m m w U m 0 0 m R, o O O O v v O O C G1 � r � D AO � A ro � O D D (/� O A U p cDn vDi vDi uDi z Z z m � O m G cn cn cn to A m ;U A -1 m O m 9 GJ CO co o A z 2 t O o m a a` OG7 D A 0 C) A A G7 G) � � a A 0 0 v 0 0 0 0 0 � W°' m n UD o tD c m O tTtp �J QNi ��tpp ONi cu 0 t0 tD mt�D tb tOp Ohoouu m cl N z O W T D1 7 61 CITY OF TIGARD DEVELOPMENT SERVICES 11L1I#. . . G PERMIT PERMIT #. . . . . . . : BUP98--0398 13125 SW Hall Blvd., Tigard,OR 97223(503)639.4171 DATE I'SSLIED: 04/01 /99 PARCEL: 15133CC-00402 5I TE ADDRESS. . . : 14176 SW BARROWS RD #1.2XX SUBDIVISION. . . . : 7ON I NG: R--`5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION:TIG RF"ISSLJE: I FLOOR AREAS---_..____..__..-_ EXTERIOR WALL CONSTRUCTION- -CLASS OF WORM. :N .W </�+- �F I RST. . . . : - 0 5f N: S: E: W: f YPE OF USE. . . :MF" SECOND. . . : 0 s f r'RnTECT TYPE OF CONST. :5-- 1 HR . . . 1 0 f N: S: E: W OCCUPANCY GRP. - PI. TOTAL----------: 0 f ROOF CONST: FT.RE RET^ : OCCLIPANCY LOAD: 0 BASEMENT. 0 sf AREA SEP. RATED: STOR. : 0 FIT: 0 ft GARAGE. . . : N f OCCI.; SEP. RATED: SC)MT'' : ME=7 Z^ : REDD SETBACKS__..__._ - . _ - RED.L)I F L_OOR L-OAD. . . . : 0 ps f LEFT- 0 ft: RGHT: 0 ft: FIR Sr'KI._:Y SMOr' T Dt- '. . DWELLING L)N I TS: 0 FRNT: 0 ft REAR: 0 ft FIR AL_RM: HND'I CP ACC: BEDPMS: 0 BATHS: 0 IMS' SIJRFACE: 0 PRO CORP: PARKING: 0 VAL..UE. $ : 9331 Reinarks : Sprinkler system for a new five (5) unit r,,' i-family dwelling. Owner: _ ______.____.____________..__._____.____ ._.__.___.______..___._ FEES BARROWS LLC/POLYGON NORTHWEST type amoi_int by date recpt E-700 NC ANDRESON PRMT f B0. 50 GEO 04/01 /99 ':39-3142: 0 D SPCT f 4. 03 GEO 04/01 /99 99314220 VANCOUVER WA 98661 FIRE f 32. 20 DRA 03/16/'39 99-313714 Ph)on e #: .360-695-7700 Contractor: FIRE SYSTEMS WEST INC 600 SE MARITIME AVE #300 VANCOUVER WA 98661 Ph ri n a? #: 360-693-9906 f 1 16. 73 TOTAL Reg #. . 49732' ---RED.LI I RED ACTIONS or INSPECTIONS------- This NSPECTIONS----- - This permit is issued subject to the regulations co!tained in the Sprinkler Rol.igh _ Tigard Municipal Code, State of Ore. Specialty Codes and all other Sprinkler- Final 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 tr, follow the _ ___.... . rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952101-0010 through OAR 952-00101967. You many obtain a copy of these rules or direct questions to Ol1NC by calling 15031246-1987, P e r m i t t e E, S i g n a t!r e: I s s 1.i e d By: + +....++++++++++++++++.++A.++++++++++i.+++++++++.+.++++++++++...................... Ca]. 1 6.39-41'75 by 7:00 p. m. for an insper_,tion needed the next bi.isiness da-,- 4+4........V++++4-++++-I ...............f-++ ay-1 ++•++++++-F++++4-++++--h.+++++++++•+++-1-+-I ++-i.++++++F+•h++++f++++++++++-++.h+++++++++++ Fire Protection Permit Application PP Plan Check# > _ :IT`•r OF 7: ARD Commercial or Residential Reed By_�_-A 1 13125 SW HALL BLVD. Date Recd TIG ARD, Ork S1223 Print or Type Date to P r. _ (5173) 639-4.174 x. 364 Incomplete or Illegible applications will not be accepted caro to DST_��;� 3� Permit# ,-G I d- i? Called (^ Job Na ru`,wellnenv1.76 A Ag O Type of System (Complete A or B as applicable) Adidin,*a 1 �o,,�s =40 ;2: A.)Sprinkler Wet Dry E] ~'-- N. / Standpipes ��7�i7)C%n OY h�tS I Mallin /ldOhas Hazard(3 oup Owner Additional r D E n !;' fla( nary CrerK C y/State Zip Phone Information Denstty n d 1,31S -- Name Design Area Or:CUp^nt MailingAddresa K.Fkaor CttyiSta'e — — zip -Phone __TT) _Sprinkler Project Valuation Contnctoc E.) Name Fire Alarm I �� f (Sprinkler or 5 re1-S WeE f Alarm company) Mailing Ackfress _ Submittal Shall Include Battery Calculations YES p Prior to permit 6040 I r►"Q t/�'� Individual Component YES C]Issuance,a Citylstate Zip Phone Cut Sheets _ COPY a� of all licenses JimJtIGC+/!i"� iDG - 9 - B.1) Fire Alarm Project Valuation $ are requ red if State Const.Co t.Bojrd Lic.0 Exp. Date _ expired In COT /1 Prol,ect Valuation Subtotal(A &or B) $ T -database tl Z- arno Permit fee based on valuation $ h r r ✓Q _ (e chart on back) •�j Architect Melling Address -'^ 5% Surcharge $ 1�N.s- se-a d City/State zip Perone FLS Plan Review 40%of Permit $ C S —f�`t> Z•2�� Describe work A.)NewAddition o Alteration Q Repair O _ — TOTAL $ to be done 3 B) Modification to sprinkler heeds only, -10 heads No plans required Plans required: Submit throe sets of plane,Including a vicinity map and 1. 1 Plan review required the location of the nearest hydrant. 2 1-10 _ I hereby acknowkK*that I haver read this application,that the Information given is wirers,that I am the owner or authorized agent of the owner.and that plans submitted are In complianrx with Oregnn State laws Additional rMscripflon of Work- Signature of Owner/A At Date A.)In Existing Building O New Building ,e,—_. " 3//_ Building contact Nano Phone ��, Data B.) Commercial G Residential •4 � ^ 5 ^��-'� ��--T FOR OFF[ E USE ONLY: Plat 0 No.of stories —_— - - - 07 1 Sq.Ft Motes Occupy CIM4 Type of Const u•-`on J - is\dsts\forms\tiresupr.doc 11/5;98 i I Ma/n Office Branch Office P.O. Box 2814 4060 Hudson Ave., NE Tigard, Oregon 97281 Salem, OR 97301 Carlson Testing Inc. Phone (503)684-3460 Phone(503) 589-1252 FAX (503)684.0954 FAX (503)589-1309 Special Inspection FINAL SUMMARY LETTER September 7, 1999 #99-1123K City of Tigard 13125 SW Hall Blvd., Tigard, OR 97223-8199 Attn: Building Department Re. Scholls Village Condominium Development — Building #12 14176 SW Barrows, Tigard, OR Permit No.. BUP980409 Dear Sir or Madam: This is to certify that in accordance with Chapter 17 of the Uniform Building Code, we have performed special inspection of the following item(s) per our inspection reports only: Reinforced Concrete Structural Steel — Shcp & Field All inspections and tests were performed and reported according to the requirements of Project Documents and, to the best of our knowledge, the work was in conformance with the approved plans and specifications, approved change orders and applicable workmanship provisions of the State Building Code and Standards, as well as the structural engineer's design changes, approvals and verbal instructions. Our ieports pertain to the material tested/inspected only. Information contained herein is not to be reproduced, except in full, without prior authorization from this office. If there are any further questions regarding this matter, please do not hesitate to contact this office. Respec fully submitted, RL N TFS TING, INC. r M Ewing i r Vice President A :jdk cc:, Polygon Northwest Company — Ron Lightner CT Engineering Milbrandt Architect P kVMRMEP0RT8W1NLTR%W i 12JK CITY OF T I G A R D BUILDING PERNIT PERMIT#: BUP98-00397 DEVELOPMENT SERVICES DATE ISSUED: 4/12/99 13125 SW Hall Blvd., Tigard. OR 97223 (503) b39-4171 PARCEL: 13133CC-00400 SITE ADDRESS: 14176 SW BARROWS RD 12XX SUBDIVISION: SCHOLLS VILLAGE TOWNHOMES ZONING: R-25 BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: NEW FIRST: 3,192 sf N: 1 HR S: 1 HR E: 1 HR W: 1 HR TYPE OF USE: MF SECOND: 3,026 sf PROJECT OPENINGS? _ TYPE OF CONST: 5-1 HR DECKS : 654 sf N: S: E: W: OCCUPANCY GRP: R1 TOTAL AREA: 6,872.00 sf ROOF CONST: B FIRE RET? OCCUPANCY LOAD: 12 BASEMENT: 0 sf AREA SEP. RATED: STOR: 3 HT: 18 ft GARAGE: 3,113 sf OCCU SEP. RATED: 1H BSMT?: N MFZZ?• N RFQD SETBACKS REQUIRED _ FLOOR LOAD: 40 psf LEFT: 0 ft RGHT: 0 ft FIR SPKL. Y SMOK DET:r _ DWELL,,.3 UNITS: 5 FRNT: 0 ft REAR: 0 ft FIR ALRM : Y HNDICP ACC:N BEDRMS: 12 BATHS: 15 IMP SURFACE: 0 PRO CORR: N PARKING: 2 VALUE: $ 473,649.00 Remarks: New five (5) unit multi-family dwelling. - Units Identified as DBBBD Separate plumbing, electrical and fire ala-- permits required Owner: Contractor: BARROWS LLC/POLYGON NORTHWEST POLYGON NORTHWEST CO 2700 NE ANDRESON PO BOX 1349 D-22 BELLVUE,WA 98009 VANCOUVER, WA98661 Phone: 1,IOC' - ( - -7 70C Phone: 'zj o -(,e, Reg FEES REQUIRED INSPECTIONS _ l u Type By Date Amount Receipt Erosion Control Insp 844-80� Gyp Board Insp PLCK GEO 9/22/98 $890.83 98-309369 Footing Insp Appr/Sdwlk Insp PRMT BUN 4112/99 $1,368.00 99 314444 Foundation Insp Reinf. Concrete final report PoSUBeam Ins Structural welding final rep 5PCT BORA 4/12/99 $68.40 99-314444 Slab Insp Final Inspection FIRE BON 4/12/99 $547.20 99-314444 Framing Insp (additional fees not listed here) Fireplace Insp Insulation Insp Total $10,888.78 — Shear Well Insp _ _J I Firewall insp This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987- Pennitee Signature: , Issued By: & dva (.�, Call 639-4175 by 7 p.m. for an inspection the next business day 1 CITY OF TIGARD Multi-Family Building Permit Application Plan check# &(r a, 13125 SW HALL BLVD. New Construction and Additions Date Pedd Date to P.E. i TIGARD, OR 97223 Date to DST /,?/ill I r (503) 639.4171 G� Perin Print or Type Called 2 v !W / Incomplete or Illegible applications will not be accepted Nai DevelopmenWrolect Existing Building p New Building Job 0I/5 V/, !f Gl Address Site Address 0 �, p Building Number of Units �-�j :54 -� �t rYow�, Kr�t Data Bldg# Cny/Stale Zip Existing Use of Building or Property: _ IZITI z� 72Z Nam?`R/7v Sun' property 6 c7 L Sq. Ft. of Dwelling: Sq. Ft. of Garage: Owner Mailing Address n Sun 3 2 q Cj 2 loo �c , � � /J ZZ Proposed Use of Building or Property: 7C y/State Zlp Phone V 0niouYcr)i0kd, --770b - NamX01 &'(qM No. Of Stories: General / or�u�S� ---- (:ontractor Malting Addre s suite Occupancy Class(es) x'700 ►J� �r�-�a'1 J�z� (� , - 'tkx to permit City/State 4AIp Phone �,D Type(s)of Co St ction �oi it ilnm es y Du��iV/t X66; a lrwo Vit 1 Will this project have a Fire Suppression System? are required If Oregon Const.Cont.H 7--1,:# Exp.Date expired In C.o.T. _—__ Yes Q. No [3 database (6� Americans with Disabilities Act(ADA) Name Valuation 3:,25% =$ Participation 7 •/ /r 1— / C_ornplete l�ccessibil�orm Architect //U ✓ �'/'�' Project $ J�IAddress Sul Oo Valuation ZA75 1 ��j . (a-) 'Si- Clly/state Zi Phone 2 S Plans Required: See Matrix for number of sets to submit — Ilel/� !�'� on back Engineer NameS/q _ — `� _ I hereby acknowledge that I have read this application,that the Information Moiling Address Sun; given Is correct,that I am the owner or authorized agent of the owner,and /d T_� (i X�/M U5 rA that plans submitted are In compliance with Oregon State Laws.City/State ZipPhones t,3 Signature Owner/Agent D<h� lend Z23 60IV33 '-�—�P --- Y _ Indicate type of work. New 0( Ctact son Name Phone Addition O Demolition O ( �1 Accessory Structure O Foundation Only O Alteration O (,1� C`7 QS� ��C 'l0 J " C) Repair O Other O �— Description of work: FOR OFFICE USE ONLY .'1• Y: .7 C ota: Site Work Permit Appllcation must precede or accomr+...., Z:.iiding (. ) t! AJ ermlt Appllcadon WULTINEW.DCY: (DST) M8 SEWER CONNECTION PERMIT CITY OF TIGARD - DEVELOPMENT SERVICES PERMIT#: SWR98-00267 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/12/99 SITE ADDRESS; 14176 SW BARROWS RD 12XX PARCEL: 1 S133CC-00400 SUBDIVISION: SuHOLLS VILLAGE TOWNHOMES ZONING: R-25 BLOCK: LOT: JURISDICTION: TIG TENANT NAME: SCHOLLS VILLAGE USA NO: FIXTURE UNITS: 0 CLASS OF WORK: NEW DWELLING UNITS: 5 TYPE OF USE: MF NO. OF BUILDINGS: 1 INSTALL TYPE: LTPSWR IMPERV SURFACE: 0 Remarks: Sewer for a new five (5)unit multi-family dwelling. Owner: _ _ FEES_ BARROWS LLC/POLYGON NW Type By Date Amount Receipt 2700 NE ANDRESEN D-22 PRMT BON 4/12/99 $11,500.00 99-314445 VANCOUVER, WA 98661 INSP BON 4/12/99 $45.00 99-314445 Phone: Total $11,545.00 Contractor: Phone: Reg #: Required Inspections Sewer Inspection This Applicant agrees to comply with all the rules and regulations of the Unified Sewage Agency The permit expires 180 days from the date issued The total amount paid will be forfeited if the permit expires The Agency does not guarantee the accuracy of the side sewer laterals If the sewer is not located at the measurement given. the installer shall prospect 3 feet in all directions from the distance given. If riot so located, the installer shall purchase a"Tap and Side Sewer' Permit and the Agency will install a lateral ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-001f) through OAR 952-001-0080 You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued by: ��-- Permittee Signature: <�a �,� Call (503) 639-4175 by 7:00 P M. for an inspection needed the next business day l CITYOF T I G A R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC9 DATE ISSUED: 4112/999 00423 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: IS133CC-00400 SITE ADDRESS: 14176 SW BARROWS RD 12XX SUBDIVISION: SCHOLLS VILLAGE TOWNHOMES ZONING: R-25 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: NEW FLOOR FURN: 0 EVAP COOLERS: 0 TYPE OF USE: MF UNIT HEATERS: 0 VENT FANS: 15 OCCUPANCY GRP' R1 VENTS W/O APPL: 0 VENT SYSTEMS: 0 S-i ORIES: 3 BOILERS/COMPRESSORS HOODS: 0 FUEL TYPES 0 - 3 HP: 0 DOMES. INCIN: 0 (4\S' 3 - 15 HP: 0 COMML. INr;N: 0 MAX INPUT: 0 BTU '15 - 30 HP: 0 REPAIR UNITS: 0 FIRE DAMP&'S?: 30 - 50 HP: 0 WOODSTOVES: 0 GAS PRESSURE: M 50 + HP: 0 CLO DRYERS: 5 FURN < 100K BTU: 0 AIR HANDLING UNITS OTHER UNITS: 5 FURN >=100K BTLI: 5 <= 10000 cfm: 0 GAS OUTLETS: 0 > 10000 cfm: 0 Remarks: Mechanical for a new five (5) unit riinti-family dwelling. - Units Identified as DBBD Owner: _ FEES POLYGON NW Type By Date Amount Receipt 2.700 NE ANDERSEN D-22 PRMT BON 4/12/99 $139.00 99-314445 VANCOUVER, WA 98661 PLCK BON 4/12/99 $34.75 99-314445 5PCT BON 4112/99 $6.95 99-314445 Phone: Total $180.70 Contractor: REQUIRED INSPECTIONS__ v1 Gas Line Insp Phone: bK - Mechanical Insp Reg #: (I J' `r'J Duct Inspection Misc. Inspection 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 CeWer. Those rules are set forth in OAR 952-001 -0010 through OAR 952-001-0080. You may obtain /copies of these rules or direct question, to OUNC by calling (503)246-9189. Issue B 1'�t�h. �� Permittee Signature: __ �wcrnl�,< WK� Y� Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day Plan Chock 4..9 C116?Y OF TIGARD Mechanical Permit Application Rec'd By 13125 SW d1ALL BLVD. Commercial and Residential Date Recd 2 i' TIGARD, OR 97223 Date to P.E. (503) 639-4171, x304 Date to DST_Lo f I� ' Print or Type Pemilts'dwi $—oy�� Incomplete or illegible applications will not be accepted card �''�`� -,rorLT/'_�* Narne a De"10PIAMM Med Description C� l�] I I I �� Table 1A Mechanical lode Qt Price Amt .IOb s JaeerLy�daess1 _i'`_ n„r A Permit Fee 10.00 1) FF:maoe to 100,000 BTU Address N( � i bbU',� Including duds 6 vents 6.00 �JQ nays CMylstate Zip 2) Furnace 100,()00 BTU+ �q Z Indudin$duds&vents 7.50 Nerve(or name old business)6a(( GV� ,1 3) Floor Furnace . P N Includingvent 6.00 Owner 1 f cr 4) Suspended heater,wall heater Ms*V Address i or floor mounted heater 6.00 5) Vent not included In appliance permit cityrse Zip Prwne3 L--)p,> 3.00 tat '0U Vf _-�� CHFCK ALL Boller Heal Ali Name(«name o(business) THAT APPLY: or Pump Cond Qty Price Amt _Com 6)<3HP;absorb unit to Occupant Ma"nddn-ss _ t00KBTU 6.00 _- 7)3-15 HP;absorb unit cMvtse - Zip phone 100k to 500k BTU 11.00 8)15-30 HP;absorb __ unit.5-1 mil BTU 15.00 _ contractor r i 9)30-50 HP;absorb 9J I t C& (�C�I unit 1-1.75 mil BTU _� 22.50 i`rkx to permit Address 10)>50HP;absorb unit C�l (� >1.75 mil BTU 37.50 1"uance,a copy y )p �of all ioenses tate 4 zip Picone 5 n 11)Air handling unit to 10,000 CFM are required N f I !� - _4.50 - expired in COT Oregon const cent LkN ■n Date c� 12)Air handling unit 10,000 CFM+ database 7.50_ Architect N I I 13)Non-portable evaporate cooler 4.50 14)Vent fan connected to a single dud OP Me"Address � 3.00 1'1 15 5 _ �, T- -0 0'0 15)Ventilation system not Included In — Engineer c"t'�'"'e (,U�� Phone -#:9,;-7 ��liance rtnk zip 4.50 PV ILO JILA.0 16)Hood served by mechanical exhaust _ 4.50 Descxibe work to done: 17)Domestic Incinerators New 0( Repair O Replace with like kind: Yes O No O i 7.50 ResKfential O Corrmerrdal O 18)Commercial or Industrial type uypIncinerator 30.00 PbdNional Information or description of work' — 19)Repair units ' 4.50 20)Wood stove 4.50 21)Clothes dryer,etc. [�/ 450 11-' Typed fuel: oil O natural gas O LPG O electric O 22)7ther units -7 5110, F P 4.50 I hereby w*nowledge that I have read this application,that ftie information 23)Gas piping one to four outlets r, 2.00 given Is correct that I am the owner or authorized agent of the owner,that plans sutxnkted are In compliance with Oregon Stale laws. 24)More than 4-per outlet(each) 50 Signature of OwnerfAgerf Date -- _-- *SUBTOTAL J < 5%SURCHARGE Contqd PeruName phone PIAN REVIEW 25%OF SUBTOTAL '� �-�,r� �j ? Required for ALL commercial rtnits onl 7 5- v— --- ,OTAL 'Minimum pemilt fee Is$25+6%surcharge �� "Resider lal A1C requires eke plan showing placemienl of tr 1:Vn,echpmn3.doc rev 08123/98 CITYOF T I G,A R D PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM98 00343 DATE ISSUED: 4/12/99 13125 SW Hall Blvd., Tigard, OR 972.23 (503) 639-4171 SITE ADDRESS: 14176 SW BARROWS RD 12XX PARCEL: 1 S133CC-00400 SUBDIVISION: SCHOLLS VILLAGE TOWNHOMES ZONING: R-25 BLOCK: LOT: JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: 5 MOBILE HOME SPACES: 0 TYPE OF USE: MF WASHING MACH: 5 BACKFLOW PREVNTRS: 0 OCCUPANCY GRP: R1 FLOOR DRAINS: 0 TRAPS: 0 STORIES: 0 WATER HEATERS: 5 CATCH BASINS: 0 _ FIXTURES LAUNDRY TRAYS: 0 SF RAIN DRAINS: 5 SINKS: 5 URINALS: 0 GREASE TRAPS: 0 LAVATORIES: 17 OTHER FIXTURES: 0 TUB/SHOWERS: 10 SEWER LINE: 500 ft WATER CLOSETS: 10 WATER LINE: 500 ft DISHWASHERS: 5 RAIN DRAIN: 500 ft Remarks: Plumbing for a new five (5) unit multi-family dwelling —_ FEES _ Owner: Type By Date Amount Receipt POLYGON NW N D-22 PRMT BON 4112/99 $1,093.00 99-314445 2700 NE ANDRESE VANCOUVER, 'EVA N D-2 PLCK BON 4/12/99 $273.25 99-314445 5PCT BON 4/12/99 $54.65 99-314445 Phone 1: Total $1,420.90 - Contractor: wwOM vimJ.I-tv REQUIRED INSPECTIONS Phone 1: ) t- Fintsl Inspection Water Line Insp Sewar Inspection Water Service Insp Reg#: ,� Wtster L+ne Insp PLM/Underfloor Water-SefvisA;�Insp Top-out Insp Raugh-in Insp Storm Drain Insp P-.-WUndeffloor Rain Drain Insp Tpp-Esu! Insp Final inspection Sto►mp Drain.lnsp-.- Rain Drain Map Misc, Inspection RP/Backflow Freventer Sewer Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Gide, 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 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. Issued By: �i t''- _ Permittee Signature_ _ -- Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan Check# 13126 SW HALL BLVD. Commercial and Residential Recd By TIGARD, OR 97223 ✓ Date Recd 961 (503) 639-4171 Date to P,E. Print or Type Date to DST r- - eatit 9-Q Incomplete or Illegible applications will not be accepted Related SWR S ' B" Called , " "•"t� Name of Development/P o)ect did a Job �� C Sink r 9.00 Address street Ad ss� supe Lavatory %'I 9.00 153. vo 'eU rti0r,' C] Tub or Tub/Shower Comb. 9.00 0. Bldg State Zip. Shower Only 9.00 l�. oa Cr�1_� an Na 1 Water Close/ a 9.00 �_ l�� Dishwasher < 9.00 >Y✓, ' Owner Mailing Address Suite Garbage Disposal t_-- 9.00 '317).-U, � rry -Z 2 -- Washing Machine r 0.00 CA /Stale ZJp Phone 0 Floor Drein/Floor Sink 2' 9.00 �Cl�UIlV�� bblr+l Leto - Name 3- 9.00 / 4' 9.00 Occupant Mailing Address Suite Water Heater O conversion O like kind 9.00 _ Gas pipirgrequires a separate mechanical permit. _ City/State Zip Phone Laundry Room Tray 9.00 _ Urinal 9.00 Name � f' 1(e 11 i�( Ower Fixtures(spedfy) 9.00 Contractor Mailing Addre - 0.00 9.00 Prior to permit /State �.(� �j� Phone �jO1j Sewer-1st 100' 30.00 2� • d Issuance,a copy L 1`' > >� Sewer-each additional 100' 25.00 of all licenses are Orego Co 1.Cont.Board Uc. Exp.Date r u �' Water Service-1st 100' 30.00 rr,• required If :�$ $- 7--`� 1 ee expired In COT Plumbing U • .Date Water Service-each additional 200' ! 25.00 0. c ep database 7 - �41 ' I5 1 -30- 1y Storm 6 Rain Drain-1s(100' 3000 e Name Storm R Rain Drain-each additional 100' !' 25.00 !G Q Architect m��s - Mobile Home Space 25.00 Mailing Address Suite Commercial Back Flow Prevention Device or Anti- 25.00 Or W I V-:� is c. '(� t- �(� Pollution Device Engineer city/StateResidential Backflow Prevention Device' 15.00 it'UI IF' �t'ff C � -11 0 Onigation timing devices require a separate Desai work to tse done restricted energy permit.) New Repair O Replace with Eke kind: Yes O No O Any Trap or Waste Not Connected to a Fixture 9.00 Reslde al O Commerdal O Catch Basin 9.00 Additional description of work: Insp.of Existing Plumbing 40.00 twr,nr Specially Requested Inspections 40.00 rmr ec) Rain Drain,single family dwelling 30.00 •" Are you capping,moving or replacing any fixtures? 0 00 Yes O No O Grease Traps If yes,see back of form to Indicate work performed by QUANTITY TOTAL fixture. FAILURE TO ACCURATELY REPORT FIXTURE Ivxnetricordwdiagram hregul„drQuerhtxyTotal Is >s WORK COULD RESULT IN INCREASED SEINER FEES. *SUBTOTAL I hereby acknowledge that I have read this application,that the Information given is cored,that I am the owner or authorized agent of the owner,and 6%SURCHARGE that plans submitted are In compliance with Oregon Slate Laws. Signaturrr of Owner/Agent Date "PLAN REVIEW 25%OF SUBTOTAL Reciuked only. Wxe qty_btal Is_9 -- TOTAL Co Person _ J-4 - . Phone "'''' -' '"'-' � *Minimum permit foe Is$25+59G surcharge except Residential Backflow - I r�-= Prevention Device,which Is$15+5%surcharge '-"All New Commercial Buildings require plans with tsometric or iser diagrim ►;� and plan review A•t*l C*rm W+doc 72819 t rµ'#. (;.3, 1t. i r• i l r (/� ;a, • ! - , r 1 r 7(41 I CITY OF T I G A R D BUILDING PERMIT PERMIT#: BUP1999-00131 DEVELOPMENT SERVICES DATE ISSUED: 4/19/99 13125 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 1S133CC-00400 SITE ADDRESS: 14176 SW BARROWS RD 12XX SUBDIVISION: SCHOLLS VILLAGE TOWNHOMES ZONING: R-25 BLOCK: LOT: JURISDICTION: TIG REISSUE: FLOOR AREAS _ EXTERIOR WALL CONSTRUCTION _ CLASS OF WORK: FPS FIRST: sf N: S: E: �W: TYPE OF USE: MF SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: sf KOOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED _ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : Y HNDICP ACC: BE:DRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 1,378.00 Remarks: Add fire alarm system Owner: Contractor: POLYGON NORTHWEST PRAIRIE ELECTRIC 2700 NE ANDRESEN 6000 NE 88TH STREET D_22 VANCOUVER, WA 98665 VPRIo OUVMF 6W798861 Phone: 360-573-2750 Reg #: LIC 60178 FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Fire Alarm FIRE GEO 4/1/99 $10.00 99-314197 Final Inspection PRMT BON 4/19/99 $25.00 99-314626 5PCT BON 4!19/99 $1.25 99-314626 Total $36.25 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987. Pemiitee Signature: Issued By: .(,�Q�l�,(i -- Call 639-4175 by 7 p.m. for an inspection the next business day Fire Protection Permit Application CITY OF TIGARD Commercial or Residential elan check N SSC Recd By 13125 3W HALL BLVD. Date Recd 77 - TIGARD, OR 97223 Print or Type Date to P.E. (603) 639-4171, x. 304 Incomplete or illegible applications vvill not be accepted DO*to DST. - 1X� Permli til Called °fpwy�r Type of System(Complete A or 8 asapplicable) Job Address, ! r. A.)Sprinkler Wet p Dr-.50a tlLwy Cj � / _ Standpipes �T��'•e_�� Id e Owner Additional H"�ro Oroup —� z Pltone Information Density -- Design Area Occupant Marg Address — K.Fodor city/State — 7.ip Phone ___ A.1) Sprinkler Project Valuation S Co Victor N'�/'CcI✓/G B.) Fire Alarm �----- M"ceryl *gAddress -� _ Submittal Shell Include BatteryCaIct4 t m Yt:g C] Prior to permit M0 CA tawence.a Clty/Staba Zip Phone iroNiduat Componerd YES j— copy Cut Sheets Of s�Ilosnses ��'��J"' B.1)Fire Alarm Project Valuation $ - are required re Const. Boarei Lk:.t Exp.Date 6O f Protect Valuation Subtotal(A a or B) 3 Permit foe based on valuation J=J� rachart on back Z✓5:OGS Architect M' se 6%Surcharge $ �- city Zip Phone FLS Plan Review 40%of Permit $ Describe wok A.)Nw&7K Addition n Alteration o Repair C to be done: -----_—_.___�_-.�..�_.____ TOTAL $ B)MlodMgtlan to i4xinkler heeds only: 1. 1-10 treads-No plane regrdred Plans required: SubmA%reg seta of plans,Including a vicinity map end 2. 11+.Plan review requiredthe locatkm of the nearest hydrant. r hereby at wavledpe that t have read this appiicatlan,that the hWmnaW-n pica,is N1 mtW Of prinkist hook: COO mi,that I em"owner Of auBarltad at ent of the own0r,and thel plans submnbd ltional Description of Work: aro In convftnoe V M1 oregm stat bws, sirmbrre of Date A.)In Exis"atMing (J New&-Ildhg- lam. Building conte P W" Phone — - -- __.I Data e.) cornmer>rlai C) Reskte,MmI n_ : itGr� X193 s`f�_ ��, -` FOR 00ME USE ONLY: No of.tortes: ---- --- Plat 13 Ski;. �7 'w+•• f'� w.,i�1 s"WA �, sq.Ft NoUf 1. Type of C,rywO,strudlon i kista\farmslfireaupr doe 11/5/98 CITY OF TI GA R D CERTIFICATE OF OCCUPANCY DEVELOPMENT SERVICES PERMIT#: BUP98-60397 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 04/12/1999 PARCEL: 1 S 133CC-00400 ZONING: R-25 JURISDICTION: TIG SITE ADDRESS: 14176 SW BARROWS RD 12XX FILE COPY SUBDIVISION: SCHOLLS VILLAGE I BLOCK: LOT: CLASS OF WORK: NEW TYPE OF USE: MF TYPE OF CONSTR: 5-1 HR OCCUPANCY GRP: R1 OCCUPANCY LOAD: 12 TENANT NAME: SCI IOLLS VILLAGE TOWNHOMES REMARKS: Scholls Village Townhomes, Building#12, Units 1, 2, 3, 4, 5, Final Building Inspection and Certificate of Occupancy Approved 12/10/99 by Rick Bolen, Building Inspector Owner: BARROWS LLC/POLYGON NORTHWEST 2700 NE ANDRESON D-22 VANCOUVER, WA 98661 Phone: 360-695-7700 Contractor: POLYGON NORTHWEST CO PO BOX 1349 BELLVUE, WA 98009 Phone: 360-695-7700 Reg #: This Certificate grants occupancy of the above referenced building or portion thereof and confirms that the building has been inspected for compliance with the State of Oregon Specialty Co s for the group, occupancy, and use under which the referenced permit was issued. ) BUILDING INSPECTOR BUILDIh) d* ICIAL POST IN CONSPICUOUS PLACE �► ELECTRICAL PERMIT CITY OF T I G A R PERMIT#: ELC98-00581 DEVELOPMENT SERVICES DATE ISSUED: 4/12/99 13125 SW Hall Blvd..Tiqard. OR 97223 (503) 639-4171 PARCEL: 1 S133CC-00400 SITE ADDRESS: 14176 SW BARROWS RD 12XX SUBDIVISION: SCHOLLS VILLAGE TOWNHOMES ZONING: R-25 BLOCK: LOT : JUR!SDICTION: TIG Proiect Description: Electrical for a new five (5) unit multi-family dwelling. RESIDENTIAL UNIT TEMP SRVC/FEEDERS _ MISCELLANEOUS 1000 SF OR LESS: 53 0 - 200 amp: 0 PUMP/IRRIGATION: 0 EACH ADD'L 500SF: 3 201 - 400 amp: 0 SIGN/OUT LINE LTG: 0 LIMITED ENERGY: 0 401 - 600 amp: 0 SIGNAL/PANEL: 0 MANF HM/SVC/ FDR: 0 601+amps - 1000 volts: 0 MINOR LABEL (10): 0 SERVICE/FEEDER _ BRANCH CIRCUITS _ ADD'L INSPECTIONS 0 200 amp: 0 W/SERVICE OR FEEDER: PER INSPECTION: 0 201 - 400 amp: 0 1st W/O SRVC OR FDR: 0 PER HOUR: 0 401 - 600 amp: 0 EA ADD'L BRNCH CIRC: 0 IN PLANT: 0 601 - 1000 amp: 0 _ _PLAN REVIEW SECTION 1000+ amplvolt: 0 >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: 0 SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: G1 POLYGON NW `r l e 1- Y _ QV'le 2700 NE ANDRESEN D-22 ("<to 1JC_, q'vv- VANCOUVER, WA 98651 VatiV-PUJ("V (-OPA l�UU" Phone: Phone: ;51x0 - r;--1;3 Z-1 S/) Reg #: FEES Required Inspections _v Type By Date Amount Receipt RoughS Elect'I Service PRMT BON 4/12/99 $625.00 99-314445 Elect'I Final PLCK BON 4/12/99 $156.25 99-314445 5PCT BON 4/12/99 $31.25 99-314445 Total $812.50 This Permit!s 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 clays 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 952-071-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246-1987 Permit Signature: ( h Issued By: ,OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or ren OWNER'S SIGNATURE: --- _ DATE:___ CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: -'-)AA �� It�� ur{1 DATE: LICENSE NO: Calll 639-4175 by 7,00pm for an inspection the next business day s CITY OF TIGARD Electrical Permit Application Plan check N_. 13125 SW HALL BLVD. Rec'dBy .J. TIGARD OR 97223 t1 j Date Rec'd Date to P.E. lif Phone (503)539-4171, x304 Date to DST L Print or Type Inspection (503) 639-4175 tete or illegible will not be accepted Permit If Incomplete ili �� 58 Fax (503)684-7297 p g p Called_L� � elifw 1. Job Address: 4. Complete Fee Schedule Below: rq yr 1 ,(R f Name of Development_ ` a --e- Number of Inspections per permit allowed Name(or name of business) ll rine? «� Service Included: Items Cost Sum Address \ /JI r S 4a. Residential-per unit �+ 1000 sq.ft.or less $110.00 4 City/State/Zip_-_1I4ai'd 1 0 k 67_ -7 Z1 , Each additional 500 sq.ft.or J I portion thereof „ _ $25.00 1 ) Commercial El Residential Limited Energy $25.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $68.00 2.a. Contractor Installation only: (Attach copy of all curr II en�tes) � 4b.Services or Fenders Electrical Contractor / L� Installation,alteration,or relocation 200 amps or less !_ $60.00 2 Addie S - 201 amps to 400 amps $80.00 _ 2 City State_�l� Zip 401 amps to 600 amps $120.00 2 c 601 amps to 1000 amps $180.00 2 Phone No. t�U �� 7'� �- Over 1000 amps or volts $340.00 2 Job NO.___ Reconnect only $50.00 __ 2 Elec.Cont. Lice. No. - Exp.DateG/�_/ OR State CCB Reg. No._ Exp.Date 5 4c.Temporary Services or Feeders COT Business Tax or Met[n_N�._ , �E Date 12 Installation,alteration,or relocation- 200 amps or less $50.00 2 n_y �� 201 amps to amps $15.00 2 Signature of Supr. Elec' 600 401 amps to 600 amps $100.00 2 Over 600 amps to 1000 volts, Ucense Nr _ S lb Is _Exp.Date -1see"b"above. Phone Nr 4d.Branch Circuits New,alteration or extension per panel 2b. For owner installations: a)The fee for branch circuits with purchase of service or Print Owner's Name__ _ feeder tee' Each branch circuit _- $5.00 2 Address__ b)The fee for branch circuits City_ ___ State_-___ Zip _ without purchase of Phone No.__ __ service or feeder fee. First branch circuit $35.00 2 The installation is being made on property I own which is not Each additional brhnch circuit_ '0 -- 2 intended for sale,lease or rent. 4e.Miscellaneous (Service or feeder no,Included) Owner's Signature. __ Each pump or irdgaf,on circle $40.00 2 Each sign or outline lighting �_. $40.00 _ 2 3. Plan Review section (if required):' Signal circult(si or a limited energy panel,alteration or extension $40.00 2 Minor Labels(10) __ 3100.00 Please check appropriate Item and enter fee In section 5B. 4 or more residential units In one structure 4f.Each additional Inspection over �-Service and feeder 225 amps or more the allowable In any of the above System over 600 volts nominal Per inspection `_ $35.00 Classified area or structure containing special occupancy Per hour _ $55.00 as described In N.E.C.Chapter 5 In Plant $55.00 Submit 2 sets of plans with application where any of the above apply. 5. Fees: �a$, Not required for temporary construction services. 5a.Enter total of above fees $ 5%Surcharge(.05 X total fees) $ NOTICE Subtotal $ 5b.Enterof line for PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review N required uir (Sec 3) $ NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal 1 IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY El Trust Account N TIME AFTER WORK IS COMMENCED. Total balance Due 11nSTs\FLC,X APP Rev W96 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -' BLIP —_ _Date Requested— AM PM — BLD Location_ Suite / —�_ SME 20T - Ph (,r `� �7 I PLM Contact Person _ .— - - — Cuntractor — _—_ Ph SWR BUILDING Tenant/Owner ELC �obb'u0 J Retaining Wall ELR Footing Acr'ess: FPS Foundation Ftg Drain SIGN Crawl Drain Inspection Notes-. - Slab _... ____ __ - SIT Post&Beam Ext Sheath/Shear 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 SAIL ANIC Post& aain �� -- --- — - Rough In _ — Gas Line --- _T-- Smoke Dampers — ----AS PART FAIL(VU _ CTR "A —.--.__ ---- - Servic. ---- - Rough In UG/Slab Low Voltage Fire Alarm AS PART FAIL — S Backfill/Grading --- — — Sanitary Sewer Storm Drain [ ]Reinspection fee of$ _required before next inspection. Pay at City Hell, 13125 SW Hall Blvd Catch Basin [ ]Please call for reinspection RE. — — [ ]Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date Inspector Ll .__-- Ext Oilier Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY O F T I G A R DELECTRICAL PERMIT PERMIT#: ELC2000-00124 DEVELOPMENT SERVICES DATE ISSUED: 3/22./00 13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639 PARCEL: 1S133CC 80121 SITE ADDRESS: 14176 SW BARROWS RD 12-1 ' I f SUBDIVISION: SCHOLLS VILLAGE CONDOMiNUMS �/� ZONING: R-25 BLOCK: LOT : 12 ' Y ISDICTION: KIN Proiect Description: Installation of one branch circuit. 94r _ RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS_ 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: 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: T 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: >=4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: _ SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: — Owner: Contractor: RICHARD DEXHEIMER ELECTRIC INC 14176 SW BARROWS 12-1 10639 SE FULLER ROAD TIGARD, OR 97223 MILWAUKIE, OR 97222 l Phone: Phone: 786-0886 Reg #: SUP 2514-S LIC 00043975 ELE 26-321C FEES_ Required Inspections _ Type By Date Amount Receipt Elect] Service PRMT DEB 3/22/00 $37.50 0000847 Eleci'I Final 5PCT DEB 3/22/00 $3.00 0000847 Total $40.50 This Permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR Spedalty Codes and a!I 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 JAR 952-001-0080 You may obtain copie�.o'[iiese rules or direct questions to OUNC at(503) 246-1987 PERMITTEE'S SIGNATURE L ISSUE(BY: ` l )a �//&* OWNER INSTALLATION ONLY 1 he installation is being ma.;e on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: 1 1 AA!It ��` �G _ DATE: _ LICENSE NO: = Call 639-4175 by 7:00pm for an inspection the next business day OS,"Ll'DO ACU 0:1:Y:. F E;O CITY Oi' 'T lCAitl> 11002Plrn C CITY OF TIGARD Electrical Permit Application Reid gy UP 13125 SW HALL BLVD. Date Recd�_d TIGARD OR 67223 Date to P.E. �- Date to DST _ Phone(503)e39-4171,x34 Permrt A ELF-Slow "G1GL� inspection(503;,(539-4175 Print of Type Caked Fox(503)598-1960 Incomplete or illegible will not be accepted F,,, Addr Address' 4. Complete Fee Schedule Below: 0(C� n NWnber of Im+ owns r rmd allowed evelopmert 'C Service Included: Items Coast Sum nerno-o�f�b�us n093)� � da, q�Identlal•par unit ��f_1_`��f—`==_/ �� low an ft or leu/Zip"_1 ?� Each additln•a 500 eq rl.or ponlon thercctial❑ Re's0entlal❑ UmI13JEech Winurd Hoar or ModularDweNl-l7 Sennas 0-Freie• 12.'5 2 ntractor instrs!lation only: anrth,asuacrea,applicants must provide scvrtractor license 'installation,tbiaAeret onaoroelo�atlon I Information rot COT data bpo; 200 or"or 1ass1 64.25 2 Ele 1cal Contractor�-E `', . 201 amps to s00 amps "—s e5.5D 2 1 ..� n - 401 amps to 600 amps f '28 50 2 Address.�g1�ia-5 s 192.50 z C n,,, J Stgte,j�• _zip P. -� e01 amps to'000 an PI.It r1�E'�*'-'_ Over 1000 amps or volts f 36375 2 Pho No _ .a.(� �'' RAI_ Recornrd only S 63.10 2 ,lob No. Temporary Services or Feeders Eltk,Cont.LIoE.No.�.t "tip-EKp.Date.I Z lneta'Isllon,akarolla, 0!-ehcrlon OR Starts CCB Reg No �i 3 c E>:p Uaea r 200a r,�or leas s a. 2 COT BUSlness Tar or Metre No. ____ Exp Date Y01 amps to 40C art ps �_ 6 00.25 2 401 amps if 600 amps ; 100.DJ 2 Si®nature of Sap, + Elec'n ----- over Boo nems m 1000 volt . one"b"above. License No �,r- l �.._.___�.Et4� - - 4d.Branch Circuits Phone No Q n p 0 i New,aFankOn or extension per panel e)The tee for branch dreulls Zb. For owner inataliawith purchase of service or dons; fees 1l". R.35 ! Eech brendi circul• Print Owner's Name b)T►te tee k•bro,ich dare Is Address __..____ -------- — wAhow.pur:hase of service City Stats rip — Firsrncf'"lo rca 1 __L_ s 37 10 j SG Phoie No _ --- Earn addktole br.rcn circuli f 5.35 The insts'lation Is being r lode on prope'ty I 0�vn which is not ,seMlls loot ouder not rrduder.; mended for sale,Ie86s of rent. Eech pump or htlgaton clyde S 42.75 Each sign or outline kd'Alnp S 4s,It5 Owner's S gnsture�___,_— Signal cl,aa(s)or a limkec energy panel,9111or extenslr s eC.00 3. plan Review section (It required):' Minor Label,(10) �� 6 100.00 Plwae check appropriate Item and enter Petr in section Be. 4f.Each addlbonal htepection overthe allowable In any or the above 6 sc.00 4 or more naklen lel.!n G In err a!ru3tare Dar Inspection f 6c.00 Servlct end feeder 225 amps cr mo•A Par hour — i System over 800 vtAts r,crn nal in?lent I OlassHAd area or et•uctWrs oontar rg Wdal orvpenet as 13. Fees: described In N.E C.Coote;5 ea.Enter total of move fees • application where any of the above apply. 5`b sumharye(rA t toter roes) C> !Submit 2 gala of plana with nttrtrcoon services. subtotal :�--- — Not required for tempo cry ob.Enter 256 of Ire tis Air NQ110E Ren Revew 11 Muta (See.3) Subtotal — UCTION AU S NOT COMM..ENCED W-HIE VOID IF WORK 18C DAYSORIFCONSTRUCTIONRUOR (, Trust Aeeomt N WORK IS SUSPENDED OR ARt.NDONED FOR A PERIOD Or'80 DAYS ❑ AT ANY TIME AFTER IiVORK 0 COMMENCED Total Wlarrce Dile i:`datti,frrr".�\ek:vic.dnc CITYOF TIGARD _ MECHANICAL PERMIT PERMIT#: MEC2000-00087 DEVELOPMENT SERVICES DATE ISSUED: 03120/2000 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: 13133CC-80121 SITE ADDRESS: 14176 SW BARROWS RD 12-1 SUBDIVISION: SCHOLLS VILLAGE CONDOMINUMS ZONING: R-25 BLOCK: LOT: 12 JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: 'TYPE OF USE: MF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APDL: VENT SYSTEMS: STORIES: BOILERS/COMPRESSORS_ HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INC IN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 3C 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: > 10000 cfm: Remarks: Install 1 air condition unit and 1 electronic air cleaner. A/C unit,cannot be placed withing the required setback areas. Owner: FEES LARRY RICHARDS Type By Date Amount Receipt 14176 SW BARROWS PRMT KJP 0:;120120( $50 00 0000776 12-1 5PCT KJP 03/20/20( $4.00 0000776 TIGARD, OR 97223 Total $54.00 Phone:503-350-6438 Contractor: OREGON COMFORT HEATING INC HUGHES, RON PO BOX 190 REQUIRED INSPECTIONS EAGLE CREEK, OR 97022 Cooling Unt Insp Y __ Phone:650-2933 fax Misc. Inspection Reg #:LIC 00042519 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 done in accordance with approvers plans. This permit will expire if worts is not started within 180 days of issuance, or if worts 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)246-918 Issue B;j: i e�'�•�_w,ti Permittee Signature:_ ---_ Call (503) 639-4175 by 7:00 P.M. for inspections needed the nfxt business day Plan Che CIT! OF TIGARD Mechanical Permit Application Recd Bye M25-6W HALL BLVD. Commercial and Residential Date Recd_ TIGARD, OR 97223 Date to P.E. (503) 619-4171, x304 Date to DT,}— Print or Type Permit# 10 C C QQC-gX Incomplete or illegible a plications will not be accepted called Namm of Dew lopment/Prolect Description �)o- I L J,� I c+ Table 1A Mechanical Code _ Price Amt Jib Street Addreso suMe# A Permit e 10.00 Fe I) Furnace to 100,000 BTU Address 1' 1 Sw -r including ducts&vents 6.00 Bldg# Cmy/Stata Zip 2) Furnace 100,000 BTU+ I r_� t 1 a� _ including ducts&vents 7.50 Name(or name of business) 3) Floor Furnace Owner I u, 1�tchu5 inclulingvent 6.00 4) Suspended heater,wall heater Melling Add ss tt or floor mounted heater _ 6.00 1411t" "-,L'� 5CLWf„.o 1 5) Vent not included In appliance permit CRY/State Zip Phone 3.00 �q5 'Boller Heat Air Noma r name of business) THAT APPLY: or Pump Cond Qty Price Amt Com 'i,ru L,5 0X(1.4" 6)<3HP,absorb unit to Occupant Mailing Address 100K BTU y I 6.00 7)3-15 HP;absorb unit CRY/State Zlp Phone 100k to 500k BTU 1 11.00 8)15-30 HP;absorb unit.5-1 nol BTU _ 15.00 _ Contractor Name 9)30-50 HP;absorb L fY unit 1-1.75 mil BTU 22.50 CCm Prior to permit ding cess l 10)>50HP;absorb unit issuance,a copy 190 >1.75 mil BTU 1 37.50 of all licenses CR /State Zlp Phone 11)Air handling unit to 10,000 CFM are required 4.50 expired In COT Dreg const.Cont.Board UC.# Exp.Date 12)Air handling unit 10,000 CFM+ database _'— ! / 7.50 Architect Name 13)Non•portabi, evaporate cooler 4.50 or Melling Address 14)Vent fen conne ted to a single dud 3.00 15)Vent',.jtion systen not Included In Englneer CRY/State Zlr Phone appipance permit 4.50 16)Hood served by mt chanical exhaust 4.50 Describe work to txe done: 17)Domestic Incinerators New 0 Repair O Replace with like kind. es O No O _ 7.50 Residefoial 0' Commercial O 18)Commercial or industrial type Incinerator _ 30.00 Additional Information or description of work: 19)Repair units 4.50 20)Wood stove _ 4.50 21)Clothes dryer,etc. 4.50 Type of fuel: oil O natural gas O LPG O electric Gl� 22)Other units I 4.50 4.f) I hereby acknowledge that 1 have read this application,that the information 23)Gas piping one to four outlets —� e r'Yie L given is correct,that I am the owner or authorized agent of -- 2.00 the owner,that plans submitted are in compliance with Oregon State laws 24)More than 4-per outlet(each) 50 Signature of Owner/Agent Date Minimum Penult Fee$25.00 SUBTOTAL 5%SURCHARGE Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL / ,\ Required for ALL commerclal permits onl J TOTAL Z _-- 'State Contractor Boller Certification required "Residential A/C requires site plan showing plaoement of unit 14mechpenn doc rev 07/20/98 3 i W n�