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L. 12365 SW KING RICHARD DRIVE .Nib.
CITY OF TIGARDrMF,-HANICAI-
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 EPMTT # :
DA-rE ISSUED: 01/15/91.3
PARCELg 2SI15BC-16200
S T"r r:7 A D D RF SS. 1 '17'365 SW V T NG R T CHO RD DF?
r;UBDTVTSION_ 7 ON I NG
SLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . JURISI)JETTON: VTKI
CLASS OF WORK. . :ALT FLOOR FLIRN. . . ,. : 0 EVAP COOLERS: 0
TYPE OF U9E. . . . -SF tJNIT HEATERS. . : 0 VENT FANS. . . : 0
OrCLJPANCY ORP. . . R3 VENTS W/0 0 VENT SYSTEMS: 0
E-3 T 0 R T rlS. . . . . . . . . 0 BOIL.FRS/COMPRESSORS HOODS. . . . . . . : 0
FtJEL TY'PE-1___1......... 0-3 HP. . . . - (A DOME!:;. TNC'TN: 0
3-155 HP. . . . - 0 COMML. TNr.TN: 0
MAX INPUT: 0 FTI.) 15;..,30 HP. 0 REPAIR t.)NITS: 0
F I RE DAMPE RS?. . : 30--50 HP. 0 WOODSTOVE9. . : 0
(3A) PRESSI.)RE. . . 50+' HP.. . . .. 0 CI-O DRYERS. . : 0
t\io. OF A.1 R HONDI. T NG (AN ITS OTHER LJNTTS. Q1
F--I-JRI\l < 100K eTIJ: 1 1.171000 (.,fiyf: 0 GAS 01-ITLETs. o
FIiRN STLJ.- 0 > 10000 rfm ; 0
PPmavI<S : Replace furnace.
Ot-iner-: FEESJ
PAUL ELLTS typr- a in n k.i n t by date Y-e .pt
12365 SW KINE RICHARD DIP PRIVIT 25. 00 DLH 01 /15/99 KING CTT`'
V,.TNG CITY OR 972,7,14 5)P C T It 1.- 25 DIA4 01 /15/99 KINE, CTTY
Phimp #:
HEAT TNG SPEC IAI.- IST INC, THE
97300 NF HAI..SFY
2E,. 25 TnTAI...
Phorip #: 0257-7000
Peg ff- 000.566
R170.01RED TNSPECTIONS
This permit is issued subject to the regulations contained in the mer-'harlic-al insr,
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final TnsF:)er_tian
applicable laws. All wrrP will be done in accordance with
approved plans. This permit will Pxpire 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 +.hroljgh OAR 952-081-0080. YOU may
obtain copies of these rules or direct questions to D!tNC by calling
F. s i.t e 0y Pr-
emitter.
4-+-4,+4..+4+.+.,+4..+4.+-4-++.+-+4+4-1 4.+4-+++'++L++4-.++++.+.++.+4-+++++4-+++++4 4-+++4--++++-4-++++++
Cal. 1 639--4175 by 7:00 p. m. far- insrler�t ions nrpded the Tir:!y t bi,js i nr ir s day
+4-++++++-4--4++++-++++-+4-F-+4 f ++-++++++++-+++-1- 1-++4-++4+++-+++44.+++++a-++++++++++++
-.TAN-15-'99 FRI 09:58 ID: FAX 140: gb5q P02
1 F� RECEIVED JAN i 4 1999
r+ri�� Plan Check 1t
rtir_.
CITY OF TIGARD DMechanical Permit Application Rec'dBy _R 13
13125 SW HALL BLVD. Commercial and Residential Date Recd -fY- y
TIGARD, OR 97223 JAN 1 1 1999 Date to P,F._
I��eLO C/� Date to DST
(503) 639-4171, x 4t,,,l , ur-YLLOPMENT, /x't 7
Permit i'1FC_49-0
Prins or Type
Incomplete or illegible applications will not be accepted c'°ed ------
-- ------- ---
(�- Nnme el Devebpmentmmi" Description
Table 1A Mechanical Code a Price An it
Job Stnwl Atltlrece - - SuMaN A) Permit Fee 10;00
t) Fu
Addresst 17_3Cos SCJ Ktn. (2.; 6tU✓d. Or macetot00,c10oBTu ,
including duuts h vents_ 13.00 6,062)
— -- - aldys chyrstata zlv �'-- fsumace 100.000 BTU+ ^—
includln ducts A v_e_ntF 7.50
Name(nr name d b.uiness) 3) Floor Furnace
Owner hQu.l E-I(1_S including vent 5,00 -
Maning AAMua ------ -- 4) Suspended h-tater,wall heater
or floor moun.ad heater _ e.00
51 Vent not Included in appliance permit -
csr/Stara Zip Phata 3.00
K t n C cr L �-19.aN. 5�9 R-113 7 CHECK ALL---- "Boller Heat Air
Name� M r�t,ex�r»+sl THAT APPLY: or Pump Co-nd Ory Pricu Amt
Com f,
6)<3HP,sbsorh unit to
'?rcupant Malang AOdr■us 1o0K BTU 8.00 _
7)3.16 HP;absorb unit
cnyrtia+e ztp vnorra 1001;to 600_k BTU 1100
8)15-30 HP;absorb
unit.5-1 mill BTU _ 15.00
Contractor Name 9)30-50 HP,absorb
I �,rr� .Spo�,alt c, T unit 1-1,75 roll BTU 2250
Prior to permit Morning Addtess 10)�50HP,absurb unit
is+mann.s MpY
q 3 tie P..)P- k L[%L54 H 1-1,76 mil BTU 37,50
I of all Ih-jonses C' IState Ztp vn?1a 11)Air handling unit to 10,00o CrM
arerequired If �inLt_=;JZtJh Q-tiu+ Z-S-1•-1mo 4_50 -
omYpirtM in GOT Oregon Cortef,Cod DOOM lits 1 ate 12)Air handling unit 10,000 CFM t
Mombasa S(n to 1-S _ �-I R-h� 7 50
Architect Name J- T 13)Non-portable evaporate cooler
Maillnp Addm 14)Vent fan connected to a single duct
or 3,U0
__-_._____- 1S)Ventilation system not Included in
Engineer civist.is- zip Pnone -- appilarics permit 4,50
16) cod served by mechanical exhaus'
4.50
De�it work to be done
17)Domestic Indneralors
New O Repair O Replace with Ilka kind r.".v No O 7 50
Renidential J Commercial O 18)Cornmerr_lal or Industrial type Inoinerntor 00
_ 3U.00
Additional information or description of work �'--__- 19)Repair units
4.30
h R 20)Wood stove
4.50 _
21)Clothes dryer,etch
4.80
Type of fuel• all O natural gas O t_PG O eledric O - 22)Other units---- -
4.50_
I hereby acknowledge that 1 have read this application,that the Information 23)Gas piping one to four outlets
ptven is;erred,that I snt the owner or authorized agent or _ __ 2.00
ine owner,that plans suDrttnted are In comrrianne whh Oregon Start lawn. 24)More then A-per m,fW(aenh% -
.50
Signature of(rwrlarfApenl �. �-�- - --Dale---
Minimum Permit Fee$25.00 SUBTOTAL �5
91
5%SURCHARGE I's
Conran Penton Name Phone PLAN REVIEW 25 OF SUBTOTAL
Required for ALL commarclalp!rmlts
TOTAL l a s
"State Contractor Beller Certlfloetion required
"Residential A/C requires site plan showing placement of unit
I\rnechperm doc rev 0720/98
t0'ci )3.15 q1H 31-11 Le:60 6661-St-NU[
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 BLsiness Line: 639-4171 MST _
BUP
Date Requested j '2.2.-9 61 AM PM
-, -- BLD
Location_ I'2 L,(/1Gf (��G�a ` ✓/i� Suite _ MEC ��.�. "7
Contact Person _ � ��j Ph X57-7jQ�D PLM _
Contractor _ _— Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall - ELR
Footing Access-
Foundation FPS
Ftg Drain I ---
Crawl Drain Inspection Notes: /, SGN
C
Slab -- - _-- �� �1.�11't6tC)e, SIT
Post& Beam _-_
Ext Sheath/Shear 54A�V
Int Sheath/Shear
Framing
Insulation ------- - ---- --
Drywall Nailing -_
Firewall ------ --
Fire Sprinkler
Fire Alarm - --------
Susp'd Ceiling - - ------ ---
Roof -----..-._-
Mise —- ---- - - ------ ---
Final - --- --.___---
PASS PART FAIL
PLUMBING - -
Post&Beam - --------- __ ---__
Under Slab
Top Out -- --- _
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART_ FAIL
----------
Post& Beam - ---_ --- ------ -
OUgh n -. -- --- —
Gas Line - - -- ---
Dampers i �-
PASS 'PART FAIL --
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage -� -
Fire Alarm —�-
Final -
PASS PART FAIL
SITE
Backfill/Grading --- --
Sanitary Sewer -
Storm Drain [ ]Reinspection fee of$ --required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( J Please call for reinspection RE: _ - ( ]Unable to inspect- no access
ADA
Approach/Sidewalk " 7
Other Date A-Z Inspector �---- _ Ext .
Final
PASS PART FAIL_ DO NOT RE OVE this inspection record from the job site.