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9425 SW BRENTVMD PLACE;
...,_..._......_ _. �w. .,..�.� .. e:. .� � . �. ���y, �,.� .�.».,��..w., .,.w<.,-,.
C17:' OF TIGARD BUILDING INSPECTION DIVISION �� ( if
24-Hous !nspection Line: 6394175 Business Phone: 5394171
Date Requested: !` / 97 _ A.M. P.M.I MST:+ '-
I,ocation:_ L�� 7" S )01
BUR
A
Tenant: _ _ Suite: Bldg: NEC:���
Contractor ;1� cfhone_ PLM:
Owner: Phone: 2.7 cf wf
� C:
ELR: _
BUILDING BLDt.(cue'ty __ PLUMBING M� E CAAI RI
ELECTCAL SITSITE
Site PosUBeam Post/lIcam Cover/Service Sewer/Storm
Footing Roof llndF'I/Slab ou - > Ceiling Water I.ine
Slab Framing Top Out as ,�r Rough•4n UG Sp>rinkl��r
Foundation insulation Sewer -
�Tt Reconnect Vault
Flsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire Spklr/Ahn Crawl/Fuuc,d Dr l leat 1'i I,ow Volt
Approved ApprovviApproved Approved
Appr/Sdwlk Not Approved Not Approved va) Not Approved Not Approved
FINAL FINAL, FINAL FINAL
C1 Call for reinspect' einspection fee of S _required before next inspection 0 Unable to inspect
Inspector Date: 2 ~
Pag4 of
CITY O F T I C A R D MECHANICAL
DEVELOPMENT SERVICES PIE RM I T
PERMIT #. . . . . . . : MEC97--0472
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED- 12/02/97
PARCEL.: 2SI11DC-05700
SITE ADDRESS. . . : 09425 SW BRENTWOOD PL.
SURD IVISTON. . . . : SUMMERFIELD NO. 9 ZONING: R-7
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :537 JURISDICTION: TIG
CLASS OF WORK. . :ALT' FLOOR FURN. . . . 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRF'. . :R3 VENTS W/O ADPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES------------- 0-3 HP. . . . : 0 DOMES. INCIN: 0
:GAS 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX TNPUT: 0 BTU 1.5--30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS". . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS----- AIR HANDLING UN I TS OTHER UNITS. : I
TURN ( 100K BTU: 0 10000 cfm : 0 GAS OUTLETS. : I
FURN > =100K BTU: 0 10000 cfm: 0
F7ernat-ks : Installing gas logs
().,4ner-: --- FEES
JACQUELINE SWINT type amai.int by date r-ecpt
9425 SW BRENTWOOD PL PRMT $ 25. 00 B 12/02/97 97-301324
JIGARD OR 97224 5PCT $ 1. 25 B 12/02/97 97-301324
Phone #-
C.ontrartor:
JOHN 0 BRANCH FIREPLACES & MOR
JOHN OSCAR BRANCH ___--_-.-_-______________.__----___-_--_
PO Box 23698 $ 2G. 25 TOTAL
TTGARD OR 97281
Phone #: 620--0255
Reg #. . : 003195A
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 184 days, ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in DAR 952-01-0010 through OAR 952-*I-@88A. You may
obtain copies of these rules or direct questions to OLW. by calling
(503)246-9187.
issue By : Pe t,in i t t e e S i v i a t 1-i Y,P
........................4..........4•................I......4-+++4........f-+4++++++++++
Call 639-4175 by 7:00 p. m. for inspections needed the next bi..isiness day
...................4-++++4..............................F++4....................1-4++
Plan(,neck#
ITY OF 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 Permit# '1 L
__ Incomplete or illegible applications will not be accepted Called
Name of Devalopment/Pm)ect Descnption
(A C c' 11,E ou ti f Table 1A Mechanical Code OTY PRICE WT
Job Street Addro Suna# A) Permit Fee -0- p 10.00 c
Address w �jc e'VA C-
stdg# City/State Zip 1.) Furnace to 10u,000 BTU 6.00
-C t la- a c� y including ducts&vents _
Nana for name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner LL' Q, tncluding duds&vents
Mall'ngAddress 3.) FloorF�mace
6.00
including vent
City/sine �Zlp Phone 4he
.) Suspended heater,wall ater 6.00
or floor mounted heater
Naris(or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp,heat pump,air Gond. 6.00
_ to 3 HP;absorb unit to 100K BUT-
CRY/State Ztp Phone 7.) Boiler or comp,heat pump,air Gond. 11.00
3-15 HP;absorb unit to 500K BTU" _
Contractor Name 8.) Boiler or comp,heat pump,air Gond. 1500
1,7 4t 15-30 HP;absorb und.5-1 mil BTU"
Poor to permit MailAddreu -- --
�,-I 9) Boiler or comp,heat p-imp,air Gond. 22.50
issuance,a copy �' 30-50 HP;absorb unit 1-1.75mil BTU"
of all licenses CRY/stele 23P Phone 10) Boiler or comp,heat pump,air Gond. 37.50
are required K .-- / - C-W-5 y >50 HP;absorb unit 1.75 mil BTU"
expired in COT Oregon Gantt.Cont.hoard Lie. Exp.Doe 11.) Air handling unit to 10,000 CFM 4 50
database _ i
Architect Name 13.) Non-portable evaporate cooter 4.50
Or Mailing Address - 14.) Vent fan connected to a single dud T 300
Engineer CHylStda Zip Phone 15) Ventilation system not included in 4.50
appliance permit
Descnbe work New O Addition O AR�eration O Repair O 16.) Hood served by mechanical exhaust 4.50
to be done Residential O Non-residential O
Additional Description of work: - 17.) Domestic:incinerators 7.50
18.) Commercial or industrial type 30,00
Incinerator
Existing use of G 19.) Repair units 4,50
building or property,
20.) Wood stove 4.50
Proposed use ofGy i ^` t 21 ) Clothe
building or property.
s dryer,etc. 4.50
=__
_ 22) Other uniLs a /_ _ , 4.50
PG O electric O 23.) Gas pipiag one to four outlets 2,00
Type of fuel•oft O natural gas 0 `tl
I hereby acknowledge that I have read this application,that the 24) More than 4-per outlets(each) .50
information given is correct,that I am the owner or authonzed agent of
the owner,that pians submitted are in compliance with Oregon State OTY SUBTOTAL
laws
Sig"re of Owner/Agent Date - 'SUBTOTAL
7
5%SURCHARGE
Cantlisqt4serson ame - )tone c� PLAN REVIEW 25%OF SUBTOTAL
-
1-e 0'!/1I-)f? J l.c/I✓1 j
// TOTAL
1:lmechpmLdoc (rev 9 'Minimum permit fee is$25+5%surcharge
"Residential A/C requires site plan showing placement of unit
2 !:)