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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
� BLIP
__Date Requested12___1z_ Al _PM _ BLD
Location / �j .� �' _ Suite MEC !1 Cl 4) 0G $3y
Contart Person q Ph (,,'2L) PLM T'7-- 0 y�—
Contractor_ Ph (0 zC SWR
BUILDING — Tenant/Owner �� �' ELC
Retaining WallELR
Footing
Foundation Access.-
i FPS
Ftg Drain I l]�� �j �> ofd (' � � r
/e ,F p - --
Crawl Drain Inspection Ncic�s. , --?)q
C� SGN
Slab C (e �9- 12 Oyl 0( -
Post R Beam -r --- - SIT
Ext Sheath/Shear 4'L -`
Int Sheath/Shear ----------
Framing
Insulation -
Drywall Nailing
Firewall ----- - - --
Fire Sprinkler
Fire Alarm
Susp'd Ceiling __-
--- -----------
Roof -------_- -
Misc: __-
Final _. --------w-.- -------_..--__ _.
PASS PARI FAIL _-__—
Post is Beam
Under Slab
Top Out --
Water Service
Sanitary Sewer -- - — --- ----
Rain Drains
�jWS FART FAIL
MECHANMA6 - _— — — — ----- -
Post R Beam _------- - ---_ _-
Rough In � V� -
Smoke Dampers
Final - --- -- --- _ -- - _ __
PART_ FAIL
ELECTRICAL _. .. - ------------------_
Service -
Rough In - - -
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading ------ ----- ----- _
Sanitary Sewer
Ston,Crain [ J Reinspection fee of$ -_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ]Please call for reinspection RE: [ J Unable to inspect-no access
ADA
Approach/Sideway, —_-
other Date �- InspectorL� . "._ Ext
Final
PASS PAKT FAIL DO NOT REMOVE this Inspection record from the job site.
MECHANICAL PERMIT
CITY O F T I G A R D
DEVELOPMENT SERVICES PERMIT#. MEC199900534
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 63^-4171 DATE ISSUED: 12/06/1999
PARCEL: 2S111 BA-02800
SITE ADDRESS: 09815 SW JANZEN C1
SUBDIVISION: MCDONALD ACRES ZONING: R-4.5
BLOCK: LOT: 003 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES. BOILER-,/COMPRESSORS _ HOODS-
FUEL
OODS-
FUEL TYPES 0 3 HP: —� DOMES. INCIN:
LPI: 3 15 HP: COMML. INCIN:
' �,X INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITOS CLU DRYER ERS:
FURN >=I OOK BTU: — 10000 cfm: GAS �_ S C'�UTLETS: 1
UNITS:
> 10000 cfm:
Remarks Installing gas woodstove, gas logs, and gas piping
Owner: _ FEES
DOUG LA.RSON Type By Date Amount Receipt
9815 SVS' JANZEN CF PRMT BON 12/06/19 $50.00 99-320183
TIGAP ., OR 97224 5PC1 BON 12/06/19 $4.00 99-320183
Total $54.00
Phone:503-620-1753 ----- — — — —
Contractor:
PACIFIC GAS WORKS
PO BOX 30646
PORTLAND, OR 97294 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503-317-5573 Misc Inspection
Reg #:LIC 136391 Final Inspection
ORIGINAI-
This permit is issued subject to the regulations contained in the T-igard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance witf- approved
plans. This permit will expire if work is riot started within 180 days of issuance, or if w)rk is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those ruses are set forth in OAR 952-001-0010 through OAR 952-001-0060.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
1 �
Issue By: Permittee Signature:
Call (503) 539-4175 by 7:00 P.M for inspections needed the next business day
Plan Check#___
CITY OF TIGARD Mechanical Permit Application Recd By CiT
13125 SW HALL. t LVD. Commercial and Residential Date Rec'd1,�.
TIGARD, OR 97223 Date to P.E.—
(503) 6319-4171, x304 Date to DST
Print or Type Permit# [Xi r7�
Incomplete or illegible applications will not be act;epted Called
—�- Name of0evelopmenUProjecl Description
f1 _Table 1A Mechanical Code at Pric3 Amt
Job Street ddress Suites A) Permit Fee �— 1600
1) Furnace to 100,000 BTU
B I C"
Address F including ducts 8 vents - 9.65
edgy yistete ZIP r 2) Furnace 100,000 BTU+
-1174, _ including ducts&vents 1200
Name(or name of business) 3) Floor Furnace
Owner i 7 at,{ee-41_ � �— including vent _- 9.65
Mailing Address 4) Suspended heater,wall heater
q,'P/5- 54! •-r+Vl z�� C_+ or floor mounted heater _ 9.65
5) Vent not included in appliance permit_ _____4.75
_
CnylState Zip Phone C teck all that apply. 'Boiler Heat Air v�
1 Q.►t� rJrG t ?C)- -? Far Items 8-10,see or Pump Cond Oty Price Amt
_ - - - footnotes 1,2 Com
N e(or name of business) _ p _
01 f,)Repair units
Occupant Mailing Address <3HP,absorb unit to — — 8.40
7)
_
100K BTU 9.55
( tdstote Zip Phone 8)3-15 HP,absorb unit
100k to 500k BTU _ _ 1765 _
Contractor Name 9) 15-30 HP,absorb
r unit.5-1 mil BTU 24,15
�t W4✓ S 10)30-50 FIFA,absorb
Prior to permit xallinQAddress unit 1-1.75 mil BTU 36.00 _
issuance,a copy 306 yG J 11)>50HP,absorb unit>1 75 mil BTU
of all licenses CRY/State Zip Phone I _ _ _ 60.15
are required H , f 1 ft • 17-sem 7 3 12)Air handling unit to 10 000 CFM � � I
expired in COT Oregon Const pont.Board LIcADate
database_ 1 _76 - ('►^ _ 7.o0 _
13)Air handling unit 10,000 CFM+
Architect Name - _ _ 11.85
14)Non-portable evaporate cooler
Or Mailing Address _ 7.n0
15)Vent fan connected to a single duct
Engineer C"y",ele zip Phnne -- 4,75
9 16)Ventilation system not included in
appliance permit _ 7.00 T
Describe work to I :done: 17)Hood served by me.hanical exhaust
7.00
New O Repair O Replace with like kind Yes O No O 18)Domestic incineratcrs
Residential*' Commercial O Modification,01 _ _ — _ 12.00
19)Commercial or industrial type incinerator
Additional information or description of worty 48.25
20) Other unit , including woof stoves
�1 .5 f45 J-= 1.00
NOTE: For Commercial projects only;Units over 400 lbs,located on the 2 Gas pipir,i one to four outlets--!
roof,require structural talcs,prepared by licensed engineer. _ Iii
� 3.75
Type of fuel: oil O natural gas O LPG O electric O 22)More than 4 per outlet(each)I hereby acknowledge that I have read this application,that the information Minimum Permit Fee 560.00 SU81 OTgiven is correct,that I am the owner or authorized agent of __�.—_ 8%SURCHARPLAN REVIEW 25%OF SUBTOTthe owner,that plans submitted are in compliance with Oregon State laws. Rcqulred for ALL commercial permits oof OwnerlAgenl DateTOTCq
Other Inspections and Fees
Contact Porson Name Phone
I hispections ou'side of normal business hours(minimum charge-two hours) 950 00 per hour
175-2 ? Inspections f,,r which no fee Is specifically Indicated (minimum charge-halt hour)
$50
Foonotes for commercial projects only: o
'+ Additionaall plan review rMwied by changes additions or revisions to plana(minimum
1 Provide full schematic of existing and proposed gas line and pressure. charge-one-half hour)$50 00 per hour
2 Provide drawings to scale showing existing and proposed mechanical 'Slate Contractnr Boiler Certhticition required
units "Residential A1C requires site plan showing placement of unit
I Vnechperm.doc rev 11/1/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: —�_—� A M. _ P.M. MS'r: _
Location -- Il l'.1-- =�� �- -��1t— — BUP: — -
Tcnant:— ��y))�_ —�� --- — -- Suite: JJ Bldg: MEC:--� qC�'
Contractor:- `_��l�dL4l�f v i Phone: L�_.lC��rJJCL_. PLM: -1-7-LCA !_ -
Ovmer: �/J 'hone:
--_—_ — C�� -- —--- ELR.N_ --
_ SIT:
BUILDING BLDG(con't) PLUMBING NEC144NICAL ELECTRICAL SITE
Site Post/Bemn I'ost/Bcam Cover/Service Sewer/Stt;nn
Footing Roof UndFl/Slab Roup]t-In Ceiling Water Line
Slab Framing 'Fop as Gas Line Rough-In IJG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconne.t Vault
Bsmt Damp Drywall Storm Furnoce 'remp Service MISC.
Masonry Ceiling Rain Drain A/C Ute,Slab
Shear/Sheath Fire Spklr/Alyn Crawl/' tnd Ir I leat Putnp Low Volt
Approved Approve'7 Approved Approved i vcd
Al;pr/Sdwlk Not Approved _ N( veil Not Approved Not Approved Not Approved
FINAL IrtA11 FINAL. FINAL FINAL
O Call fortf .xtiop O Reinspection fee of S____., reqaii-ed before next inspection O Unable to inspect
Inspector- — - Date: t ! — Page- _of_ _
CITY OF TIGARD
DEVELOPMENT SERVICESP1LUMBTNG PERMIT1 +-RMIT #. . . . . . . : 171L.1,07-029"
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATF ISSLJED: 07/23/97
PIARCEL: 2S1118n-02800
)ITE ADDRESS. . . : O98t5 SW JAN7EN CT
)IJBDIVISION. . . . : MCDONALD ACRES ZGNING: R--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :3 JURISDICTION: TIGI
CLASS OF WORK. . :AI-T GARBAGE DISPOSALS. : 0 MOBILE HOME SP,ACE:�. : 1b
T'YP'E OF USE. . . . :GF WASHING MACH. . . . . . : 0 BACKFLOW P,REVNTRS. . : I
OCCUPIANCY GRP'. . : R-:, FLOOR DROING. . . . . . : 0 J RAP'S. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . 0 WATER HEATERS. . . . . : 0 CATCH BASINS. . . . . . . . 0
F'I XTURES------ I—AIJ11DRY TRAYS. . . . . : 0 GF RAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . : 0 URINALS. . . . . . . . . . . : 0 GRFt)SF TRAP'S. . . . . . . . 0
I-AVATORIES. . . . : 0 OTHER rIXTURES. . . . - 0
TIJB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0
D T SHWASHE R9. . . 0 RAIN DRAIN (ft ) . . . : 0
ReMat-ksi . ITISt,411ing A residential bac�kfl,ow prevention device.
ownev-: F"FFS
uOIJG I—ARGON type --A"10 l.t n t t.)y date r-ecPI;
9915 SW JANZEN CT PRMT $ 15. 00 B 07/23/97 97-297472
TIGARD OR 97224 -)F,CT $ 0. 75 D 07/23/97 97—213747;:—:*
Plhone
11ODERN r-'LUMBTN(-j
11120 SW :INDUSTRIAL. WAY
'TUALATIN OR 13706i-.'
F.1htme # : 691-6166 13. 75 TOTAL
Reg #. ., : 000879 REQUIRED INSPIECTIONS
This persit is issued subject to the regulations contained it the RF1/Bac:kF1aw Pr-e P
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final I r);ectior-
applicable laws. All worts will be done in accordanTe with
approved plans. This pereit will expire if work is not started ......
within 180 days of issuance, i;r if work is suspended for sore
than 160 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification
cation Center. Those rules are
t forth in OAR 752-0001-0010 through OAR You lay
I ain copies of these rules or direct questions to OUK by calling
e e 77 j. n�a
s i-red 13 P,C,r-m i t t t
i
f ++++44......4.++-+++++4++++++++++4+4-+++•+-{•+l..+++-}-++++++-4-++*+++++4•...........1-4-+++
11 639-4175 1:)y 6,00 p. Ill, f a t- an inspection needed the next business cliv
++++++++-+++++++4•++++
CITY OF TIGARD Plumbing Application Recd e 1`
13125 SW HALL BLVD. Commercial and Residential Date Recd 7— 'i
TIGARD, OR 97223 Date to P E.
1277.77an__(503) 639-4171 Date to D
Permit tt
Print or Type Related SWR
Incomplete cir illegible applications will not be accepted Called
Name of DevelopmenuProlect -- FIXTURES (Individual) QTY PRICE AMT
nk
_ s..00Job � Lavatory
avatoryAddress suite 9.00
Tub or Tub/Shower Comb 00
lg
City/State Zip Shower Only — 9.00
1
cf 10 Water Closet 9.00
Name
(h)t_k c- U cwt Dishwasher 900
Owner Aa lin Address Suite Garbage Disposal 9.00
O� �a C(� �V1 Washing Machine 9.00
Istate'I Zip Phone Floor Drain 2' 9.00
t t- ctV(� ( 3" 1..00
Na —
4" 9.00
Ci- Jw — —
Occupant ,ailing Addre3s I Suite Water Heater —_— _ I 9.00
SLJ�CuA zt yl d _ Laundry Room Tray —L� 9.00
4tylState Zip Phone Unnal
�) r' Ct4/ or •1 v-- — � 9.00
Nai e - Other Fixtures(Specify) --- 9.00
1 '\ \ — 9.00
—
Contractor Mailing Address Sui a 9.00
ClyISlate Zip Phone I — --- 900
(L.0 1 r�-, -) C` t' 1 'Z l_r C,1 --
Oregon Const.Cont.Board Lic# Exp.Date _ — 9.00
Attach Copy of -' ) ' I (, � 9.00 —
Current Plumbing Lic.0 Exp Date Sewer-1st 100" 3000
Licenses (',_( -'J)'-, Sewer-each additional 100' 25.00
COT Business Tax or Metro 0 Ex) Date Water Service-1st 100' 30.00
Name Y Water Service each additional 200' 2500
Architect
Storm&Rain Drain-1 st 100' 30.00
Or
Mailing Address 1 9Jite — Storm&Rain Drain-each additional 100' 25.00
I
Mubile Home Space 2500 I
er
EngineCityrState ZipY Phone Commercial Back Flow Prevention Device or Anti- 2500 —II
i Pollution Device _
Desrnbe work New O Addition O Alteration 0 Repair O — Residential Backflow Prevention Device" ' 15 OU
to be done. Residential O Non-residential O Any Trap or Waste Not Connected to a Fixture 9.00 l
Additicnal description of work Catch Basin 900
Insp of Existing Plumbing — 40.00
_
per/hr _
Existing use of — Specially Requested Insnections 4000
budding or pioperty____ — per/hr
-- Rain Drain.single family dwelling 3000
Pro-iosed use of Grease Traps 900
buddw: or property
QUANTITY TOTAL
Are you capping , moving or replacing any fixtures' Yes O No❑ Isometric or r+er diagram is required if Quanrty Dotal is >9
(if yes see back of form) _ 'SUBTOTAL
I hereby acknowledge that I have read this application,that the information
given is correct.that I am the owner or authorized anent of the owner and �5% SURCHARGE
that plans submitted are in compliance with Oregon State Laws
Signature of Owner/Agent Date PLAN REVIEW 25%OF SUBTOTAL
Required only if fixture Qty total is->9 _
TOTAL
Contact Porson Name —� PhonelC—�
/ 'Minimum permit fee is S25, 5°,surcharge,except Residential 3:�ckfiow Prevention Device.which is S 15-514 surcharge
Odsts\p1m3ipp.doc 3196
PLEASE C9_ME1E AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced "Oty
Sink
Lavatory
Tub or Tub/Shower Combination _
Shower Only
_Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain 2"
_
J/�1,
An
Water Heater `i
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE: