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12375 SW KING GEORGE DRIVE i N W s Tr H z V7 H l t 1 1 I f t J d 12375 SW KING GEORGE DRIVE _. c 6C6Ll.Ji C ;D V R— Ev C� r'' U W L O > L � pp SrS � C1 L 0. a E W Q . coo 4 wj a' o0 00 00 .Q 00 �J o0 00 U LLJ u u 00 e o °1D F .y y C N ��• r; z � � � � J W - u � a a 00 rn C, °" a o b o 00 00 N v 00 00 a 21 T' Z 0 ]C y a U J IY c W c c a vaj V A Cm r 00 Vl O �r1 1/1 _f o g Q < ¢ Q •% U U U U CV U r � ( 2 \ � k ` � � /C) Z.5 � § $ � % o $ = E 2 * 2 » $ a ( � a \ w o m - z = § g .; u 3 § § 3 \ 2 \ _ > 2 � U � � 2 $ $ C R 00 It © * n ? i § | , � ƒ } $ ¥ } % J � � \ § � § & uj c 2 u x 2 z CITY OF TIGARD BUILDING INSPECTION DIVISION MST3' 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP --0 3 Date Requested AM PM _ BLD Location_ uite `'7 `" � .i✓ij'�� �. /\ l � S Contact Person _ Ph Sci `t" �. �� PLM _ Contractor _ Ph SWR — BUILDING Tenant/Owner I~ I I �� /IJ EL% Retaining Wall ELR Footing Access- Foundation SPS rl.'!`�'' j' ( / - -_ F���'�.J � Ftg Drain -- Crawl Drain Inspection Notes: (9 LAJ ( � �, SGN Slab Post& Beam n y� / SIT Ext Sheath/Shear l' ( C 1( ,M �T �j� V Int Sheath/Shear A 'u /� /� Framing Lq A l(- / SO U T- in Insulation Drywall Nailing Firewall s�•�„ /� Fire^„rinkler Fig i m Su-.n- eiling Root ..— Misc: _ Final PASS PART FAIL --- PLUMBING !n t�.q� Post& Beam -- - ---- Under Slab Top Out - -- - ----- r C� Water Service Sanitary Sewer - - - --- Rain Drains Final -- PASS PART FAIL. MECHANICAL Post& Ber;ni ---_.._ _ ._ _-------- -- - Rough—Fn- .Gas Line- Sao! ine" ----- - --- Srl oke Dampers Fina,, PASS PART FAIL. ELECTRICAL Service Rough In - UG/Slab Low Voltage _� --- Fire Alarm Final ------------ ------ PASS PART FAIL ---------_-_ SITE Backfill/Grading - ----- -- Sanitary Sewer Storm Drain ( J Reinspe--tion fee of$_ —required before next inspection. Pay at C`ty Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ J Please call for reinspection RE - _ [ J Unable to inspect no access ADA Approach/Sidewalk Other Cate _ - Inspector. ! _Ext Final PASS—PAR T FAIL 00 NOT REMOVE this "snspectioo record from the job site. BUILDING PERMIT PERMIT #. . . . . . i BUP96-0322 OF TIGARD DOTE ISSUED: 06/13/96 COMMUNITY DC-VELOPMENT DEPARTMENT 13125 SW Hall Blvt; Tigard.Oregon 97223*8199 (503)639-4171 PARCEL: i:'SlIOCC-15400 L-- 1--'31"- SW I'NiNij- 61AJR( E IJIi SUBDIVISION. . . . : ZONING% BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . -------------------------------------------------------------- REISSUEi FLOOR EXTERIOR WALL CONSTRUCTION CI-ASS OF WORK. :ADD FIRST. . . . : 235 s N., S: E: W. IYPE OF USE. . . :SF SECOND. . . : 0 !: f PROTECT OPEN I TYPE OF CONST. i5N . . . : 0 sf N: S: Ell W1 OCCUPANCY GRP. :R3 TOTAL..._-----: 235 s ROOF CONSTs FIRE RET?: rICCUPANCY LOAD: 0 BASEMENT. : 0 s AREA SEP. RATED: TOR. : 0 HT 24 ft GARAGE. . . : i s OCCU SEP. RATED: 3MT?i MEZZ?i REQD SETBACKS-------- FLOOR LOAD. . . . : 40 p s f LEFT: 0 ft RGHT: 0 ft FIR SPIKL: SMOK DET. . :Y DWELLING UNITS: I F'RNT: 0 ft REAR: 0 ft FIR ALRM: HNDICPI ACC; BEDRMS: 0 BATHS : 0 IMP SURFACE: 0 PRO CORR: PIARKINGt 0 VALUE-. f : 4000 Remacks . Re-v,00f Owner: -------------- FEES BOB AIKINS type amol-tnt by date t,ecpt 12375 SW KING GCORGE PIRMT $ 4.4. 50 CJS 06/18/96 KING CITY 5PCT .2. 23 CJS 06/18/96 KING CITY KING CITY OR 91224 Ptione 4+: 639-8230 DAVE BEARSON 1031 SE MILL PORTLAND OR 97214 1-11-inne #: 503.-233--6422 $ 46. 73 TOTAL Req #. . . 016541 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection — al plicable laws. All work will be done in accordance with Final Inspection approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for eoi,e than 180 days. Per-mittee 11C1nRtUV'Ptl ls5l..�ed By: ...... Call for inspection 639-4175 JAN-02-'00 MON 02:53 TD: FAY, N0: 4011 POI - - Jost-It"brand lax transmittal memo 7671 w of peges Residential Building Permi,T T. City of Tigard 13125 SW Hall Blvd. o�p"r: }- Phan• Tigard, OR 97223 FORS. et cr (503) 639-417117�- Jobsitn Address: _-_ 12,37,5- Sw IrJ 1�q �oesG�leu ��. 5ubdlvlsion: _ Lot S Otago Use Un-IV r FbnclvRec Valuation: T Permit# U L���r✓-L 3 '�1 Corner Lot? Y Reissue of Flag Lot? Y ® -� Map b TL# 11Sj_1 111)r c- 1�0(0 Own©r. L3O IC�►� S Iteauired_ Address _�2 _. -- Planning— ' �'`^"'L Engineering _. Phone �� Other Contractor, uR`t`` �Ql1tr,4rr I�Ite rs Required Address- E, .. Subcontractors Tros5 GCt2l{S .— Phone Contrector's License# (attach copy of current Oregon license) Contact Name & Phone: M1�' ►ttaMV3u� 1 ��`�_z3�• Subcontrairtors: Archi'ect/Englneer: Plumbing: Mechanical _-- (attach copy of current On Contractor, License) Phone JOB PE5CRIPT{ON - Applicant Signature b Phone nurnber /`� `_ Received by :Jt�� Oatw Rei-vec4 Co 7'14 � ? ? ? E § ? E @ U 2 / 2 > 2 2 < a 2 ƒ ) $ j \ \ \ / $ 2 ± ƒ f ƒ $ ~ m % - \ r } m 5 \ ) g \ 5 } \ k C ( 2 / \ CD \ \ m $ # + < m CD � @ @ @ @ o p -u 00 } k [ $ 0 m % i C) E p o Q © { % M m ° C \ � / $ƒ $ } ° 6 F y / / f § C.1) w � � } <o 2 k3 cl R 2 / k « \ { \ m m e f, E a ) q § @ f @ e A ) \ ALn CL � / i CITY O F TIGARD ELECTRICAL PERMIT PERMIT#: ELC2003-00152 DEVELOPMENT SERVICES DATE ISSUED: 3/21/03 13125 SW Hall Blvd.,Tiqard, OR 97223 (503) 639-4171 PARCEL: 2S110CC-15400 SITE ADDRESS: 12375 SW{UNG GEORGE DR ZONING: SUBDIVISION: KING CITY NO. 5 BLOCK: LOT : 006 JURISDICTION: KIN Project Description: 1 Branch circuit to HVAC. RESIDENTIAL UN!T_ TEMP SRVC/FEEDER_S_ ` —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/"ANEt.: 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: 201 - 400 amp: 1^t 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: JUNE NIELSON SPECIALTY HEATING + FABRICTN 12375 SW KING GEORGE DR 9528 SW TIGARD S f KING CITY,OR 97224 TIGARD,OR 97223 Phone: 509-639-5556 Phone: 620-5643 Reg #: LIC 66578 --- --- -- ELE 34-341CRE _ FEES _ _ SPI, 2001AR Description � mate v Amount— Required Inspections IELPf2M l I HLC I'crnui 3/21103 $46.85 —--- ---� [TAX]8°,,,StateTax 3/21/03 $3 -5 Rough-in Elect'I Final Total $50.60 This Permit is issued sub;ect to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for more than 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notrfication Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or direct questions to OUNC at(503) 246-6699 or 1-800-3.32-23 Issued By: � J7 / Permit Signature: }i,% ( Y _ I ir OWNER INSTALLATION ONLY The installation is being made on property I own which is riot intended for sale, lease, or rent. OWNER'S SIGNATURE: --- _ —__ DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: _— _ _.— DATE: LICENSE NO: - �C L4 r,..`._�- Call 639-4175 by 7:00prn for an inspection the next businoss day Mar 18 03 11 : 20a Specialty Heating 503 598 0718 p. 2 Ehwtracal Permit Application nate received: /- paunlit no.: - City of Tigard ProJcct/appl.no.: E.xpiredam: Ctrs qj Tigard Address; 13125 SW Hall 141AA T(gard,OR 97223 - - Phone: (Sfn3) 639-4171 Date lssued: _ BY' .� Receipt no.: Fax: (503) 598.1960 Cate flle no- Payment type; ^ Lund use approval: ,I 1 3t 2 family dwelling or accessory U Contmeicial/industria( o Multi-family 1]Tenant improve Bent 0 New construction ,1$A�Idttinn/alten[ion/replacement ❑Other _�. G Pgrtia! 1B Sat INWIRNIATION Job address: / 3 r- l , i r �r _ Bldg,no,: 5uitc no.: lax map/t ix lottaccount no.; Wt. _ Block. Su divisiu - ___LL_ - — Pro t.ct ne:Bai � � - —'�`-- '— -- — ,zcw�tr F Description and location of work on premises ,t — —`-- Es4mtuod dAte of completiotn/inspecdon: —� '- 1 0 dab dao: ��2f _ r•M nrz� Dusilless name: iMsfrt tion Qty (ea) 'l ocal nu,hts �ddreSS: GO/ rte. �- Nenr"identlal sirtClem m1-fd rnilyI- I ty' " G11,� S[2IC�'1�' ZIP:!"7/ Rr ehingtnwdt ci4'tclutky attached guruPr. ltonr.: i0 '9(,e Fax to tfp�3 mail: IUOU a4.ft or!es��_ -- t SCR no.; �'° 5 �,� 'r .r Elec.bus. dc.no: !3 - w'h additional-500 sq.ft.or action thetwf ---- Ci /Illr.tro tic.no.; / ldmltedclergy.iaaidenu, - — 2 _ C' _ - Littrltedenergy,non•t-st cordal 2 f2�179 / any tiach manufacturnd home or modular dwelling St re of supervising electrician(required) • -~ Date servicr,ndlorfeeder L Sup.elect vame(urint)Ale /j, rt;� Uee"unnoy� JlK1 rvicdorfec-'Trs--irsdnllurino,_._. ___. 1 altetatiou or reloeption: PROPERTY200 amps or less 2 Name(pr'nt):, uj� �� l ,n fit,. 201 amps to 400 ampv - _ _Mailln asIdlLSs:/� S _401 tun a to doo arup's - - old fol G _ - ��_— 601 amps to 1000 sups 2 City i S 8teL Z�' �J1.J'Y Over l WU snips or volts 2 Ph(i 5 ;Fax: is Iltail:owner Installation:The ination is iteing maJe on property I own Temporary serwlcraorfeeders which is not I.ntenecd for We.lease,rent,or exchange according to Msmll2tion,Alteration,orrelocation: ORS 447,455,479,670,701. 200 snips or less _ 2 Ownel's A nature: DatC: au 201 umps to 400 ,p,"' 4U 1 to 600 ams -- 2 Branch cireults-new,alleration, - iv2,rlte: or extension per panel.. Address; - - A. Fcc for branch circuits with purchase.of service or feeder he,each branch circuit City: State: B. Foe roc branch circuits without purchase 2 ... ._ ZIP: Ph ire _ -._ ---- orservine or feeder fee.fim branch circuit: Fax: C ntnul 2 -Eich additlontU branch cinvit; Misc.(Serriee or feeder not included): 0 Service,over 225 amps oonuncruinl :.1 llraidr•�arefac ility rytiach punip or irrigation curte _ Z 0 Selou uv,er 3:D unrpa-rating or ld2 0 l ammouslocatiun Each sign or ouU fine.lightltt� - 2- family Dwellings U Building over I0,rw square feel fgur or Signal circuit(s)or a limited 4nergy panel, U Systeln over Goo volts nominal more residential units In one structure alteration,orextenaion• O Building over three stories C1 Feeders.400 amps orntorc •t3ezcripdon: _ -- O Ocvupwu luad over 99iv,sons U Manufactumd strucrures or RV park - --.._- - -- �--- �- U EgressAightiugolan O Other Each odditiomtl imp-tion over the allowable in any of lite abovr- Perinlpection Submit---sets of plans wllh any of the Above, _ — �_�--,�---T-- --- InvcsUgation fee Tice alwve are eat applicable h tesulh►satry cullitltiction service. Other �- ---- --" `-"- Not dlitaisdkdam uocept nallt ands,pfwm call Junsaietion for mace infomuda,. Notices This pennit npplieatior Pt:tinit fee.....................$ _ Cl Visa 0 MasterCard expires if a permit Is not obtained Plan rrview(at _ 46) $ e".du v■,i">u"'Em: Ividlin 180 days after it has been State surcharge(846)....$ ". sprees" accepted as complete. TOTAI. ante can I al town on Credtic ••,••••••••••••••••••••$ S -- CaNho r riptature __ ,�,,,•,,,,t 440-615 ftstvetrcOMr CITYO F T i GA R D — MECHANICAL PERMIT — DEVELOPMENT SERVICES PERMIT 9: ME02003-00134 13125 SW Hall Blvd., Tigard, OR O7?23 (503) 639-4171 DATE ISSUED: 3/24/03 PARCEL: 2511 OCC-15400 SITE ADDRESS: 12375 SW KING GEORGE DR SUBDIVISION: KING CITY NO. 5 ZONING: BLOCK: LOT: 006 JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY 0.RP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: _ BOILERS/COMPRESSORS HOODS: FUEL TYPES �— 0 - 3 HP: DOMES. INCIN: LPG 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: Replace o imnacc. Owner: -- _ FEES ,TUNE NIELSON Description Date Amount — 12375 SW KING GEORGE DR --- -- KING CITY, OR 97224 IMIJ 111 I'MMI I CC 3/24/03 $72.50 ITAXI 81;,Statc I as 3/24/03 $5.80 — Phone: 509-639-5556 Total_-- $78.30 -30 _ Contractcr: SPECIALTY HEATING & COOLING 1601 SE RIVER RD HILLSBORO, CCK 97123 REQUIRED INSPECTIONS Phone: 503-640-1607 Heating Unt InspFinal Inspection Reg #: LIC 66578 This permit is issued subject to the regulations contained in . Tigard Municipal Code. State of Ore. Specialty Codes and all other applicable laws All work will be .done in accordance with approved plans. This permit will expire if work is riot started within 180 days of issuance, or if work is suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center These rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling (593)246-6699 Issued By: L Permittee Signature: �� j, Call (503) 639-4175 by 7:00 P.M. for inspections needed the next busine.- day 03/20/2003 08:48 5036393771 CITY OF KING CITY PAGE 02 SERVICE CE!'f R Nlechanical Permit Application Darr received: d3W-(1 Permit nr.11l1E% 3 4X1311 City of King City t,. V 1312$ SW Hall Blvd. ��- H L"�'..✓�1 Projert/appl,no.: Expire late:: Clackamas `igard' OR 97223 Date issued: BZa Receipt no.- Phone: (503)639-4171, FAX: (503)684-7297 Multnomah Case file no,: Payment type: Washington C o U M T I E : Land use approval: - Building permit no.: 1 r r I & 2 family dwclln a or accesfory O Commercial/industrial 0 Multi-ratably U Tenant improvement New constnlction Addiriort altr.r-atiun/replaremeni 0 Other. -JOB SITE INFORNtATION / "VALUATION11 Job address: indicate equipment quantities in boxes below. Ir'.dicate the doilar Bldg. no.: Suite no.; value of all mechanical rnar.alals,equipment. !abor,overhead, _Tax ma /tax lot/account no.: profit. Value S _ I:,ot: Block Subdivision: 'See checklist for important application inibrm cion and Project name: WSa�yv - jurisdiction's feyschedule for residsntial permit fee. City/county: 1 1101 'a ' '.1 Description and I tion o work on premises; 1 1 1 / URI _ Fe*(ea.) Total Esc,date of completionlinspection: �� d�3 ---- Deu.-rtpdon lQty. Reei.oil Rea.omv� Tenant improvement or change of use: UVA'C: Is existing space heated or conditioned?1 Yes O N< Air handling snit Air conditioning(site nn requirod) `� 1 Is existing space insulatedI Yes ❑No Alteration of existing HVA system _MECHANICAL CONTRACTOR , Boiler/cornpressors State boiler permit no.; i3usrnesc rtaazne. C � - G;, AddtH? Tons B'IUM � tw: / d i 7 - - , _. Ul.! Fire/smoke darnpe eruct smokt detectors City: p slate:v�l� ZIP:QU/�-a E eat ump(site p an required) Fax: IThPhone:(o1lQ stat rep ace furnacr�ume } =CB no.: G��r",7�/ tnuludin ductwork/vent liner GI Yea 0 No I -- — nsfi rep:~c mloca�=suspended, :ity/metro Ile•no.: /6 G wall,or floor mounted vlame(please print) ��/ /S v yn�for ap liasrce o et'F'�r than fw n_nce -CONTACT - 1 RetYigern oar Absorption units _ BTUM _ Jame: Chillers Y —HP — \ddte": / ("ohm re-vors lip E'nWanmeat� eattraust and ventilatloo: Appliance vent _ 'hone: Fax: E-mail: er exhaust _ 1 r Hoods,TI/ rcs.kitcfi-e-mNa:mat hood fire suppression system +ame: �(,tiy —�i�sp Exhaust fan with single duct(bath fans) ,(ailing address:/•a-4 .S,4,fJ i� r xhaust system apart from healir,g or AC t'._ Stater Zip:Q1�� Furd piping and distribution(ur,to 4 outlets) T LPG _N4 oil !I ne. aQ 5 Fax: E-mail: Fuep _ing eac i additional over,E outlets 1:0,111 IMI of IProees:s-piping(se emntic requiP ) a ne. Number of outlets appliance nr eqa pinent: ^ ddre55: Decorative_fireplace _ itv; -- State ZIP: Insert-type — hone: �-� E-mall: I Z wo-C_.:tov pe let stove oplicvrtt's sigrttrtuOther r 6L Ottt / Other- tme:(print �1 --- all wrindieuPes receul CMilt earde.Otda c tail JW IWluwn(or more InforMuion. Permit fse......................S Nonce, This permit application •'�s� c]MaslerC.vd h(ittimurn fee ................5 -- _ expires if a permit is not obtained Plan review(at %) $ fit mrd numba� wUhin 180 dgvs afar it has been -- °ap1r°' State surcharge(896),..,,$ Faroe of oardhnider u s own od credit card aceepted as evmptete. Cardholdersignasure AmountOKI, Xa .3 0 03/20/2003 08:48 5036393771 CITY OF KING CITY PAGE 03 r J� SITE PLAN PL PL PL I 4 PA 4- PL olt. STREET Specialty Heating & Cooling, fnc 9528 SW Tigard Street Tigard, OR 97223 Phone 503.620.5643 Fax 503.595.0718 Hillsboro Phone 503 .640.3607 Fax 503.681 .0793 CITY OF TIGA►RD 24-Hour BUILDING Inspection Line: (503)639-4175 MST ------------- INSPECTION DIVISION Business Line: 1,503)639-4171 BUP Received _ ____ _ _.__._Date Requested_- - 3 AM_ __PM_ _ BUP suite J Contact Person Ca — .__—_ Ph( --) � �a-3 Gl—oJ 7_ MEC �003r UU13 PLM Contractor-----------_--_— —_— —_� Ph( .—) SWR -- - — BUILDING TenanVOwner Footing E I-C Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post& Beam -- -------- -- - -- - --- - -- ---- _ Shear Anchors Ext Sheath/Shear - Sheath/Shear rraming _--- Insulat:ori Drywall Nailing - - - - -- —--------- ��- -- -__... --- Firewall Fire Sprinkler - --- -- - - — -- -------- ---- Fire Alarm Susp'd Ceiling -- _- - - �--- ----------_ _�— Roof Other. Final PASS PART FAIL PLUMBING_ -- Fost Under Slab - Rough-In Water Service ---- Sanitary Sewer Rain Drains - --- Catch Basin/Manhole Storm Drain --�— - Shower Pan Other: --- Final PA ---FlrtHT, FAIL CHANIL_ - - - - ---------- Rough-In - --- - - - -- - ---- -------- Gas Line ampers - -- _ ---- ----�_ -- - -_ P`kf�T FAIL - - -- - - - - --- - ---- - 'LECTRIC Sery . Rough-In UC,/Slab ----- ----- --.-__ --- Low Voltage - Fire Alarm in -� Reinspection fee of$ _ required before next inspection. Pay F t City Hall, 13,25 SW Hall Blvd. _ -- ' PRT FAIL ---- g Please call for reinspection RF:._ _— --_�__-__ --__ - Unable to inspect- no access Fire Supply Line ADADate 71.�� Inspector _ Approach/Sidewalk Ext J Other: Final DO NOT REMOVE this Inspection record frob, bo Job site. PASS PART FA!L CITY OF T MECHAN I CAL DEVELOPMENT SERVICES PERMIT 13125 SW Hell Blvd.,Tigard,OR 97223 (503)6394171 PERMIT #. . . . . . . .. ME C;9H—rr 22, DEtTE ISSUED-, i I'TE ADDRESS. . . : 1,2379 SW KING GEORGE DR IJBDIVISION. . . . : KING CITY NO. 5 7GINII1\1G: ..00E;. . . . . . . . . . : LCAT. . . . . . . . . . . . . :006 JUR I SD I CT I ON: K I N _AS."_; Or WORK. , :ftl._T FLOOR f URN. . „ r : rh EVOP COOLERS: 0 iPE OF USE. . . . :SF UN17 HEATFRC,. . : 0 VE=NT FANS. . . : 0 ;('CUPnNCY GRP. . : R:3 VENTS W/O APPL_: 0 VENT SysTEMS: roti 5TORiES). . . . . . . . .. 0 S0I1_E:RS/COMPREHSORE-3 HOODS. . . . . . . : 0 IF_L. TYPES—- - ........ ... .. ,2r. a HP,, . . . : 0 DOMES. INCTN: 0 CTAS -15 Hr,. . . . : 0 COMM1-. INrTN: 0 MAX INPUT: 171 13T1.) 15 --30 1IP. . . . .. 0 REPAIR I..)NITS: rh F I RE DAMPERS?. . : �,0-50 HP. . . . : 0 WOODSTOVFS. . : 0 '�S PRESSURE. . . 50- 1.10. . . . : 'A C'L.0 DRYERS. . : 'A fl. OF ATR HANDI. T NIC t IN T TC, EITHER LIN I TS. : 0 'JRN < 10OK STU: 0 (- 1.0000 (-fin : 0 HAS OUTLETS. : 1 Fl_)RN ? =10OV, BTU: 0 > 1.0000 c,fm: 0 Remarks. Installation of main extension for new service. CJwnev': - .._._.._..._._._. ..__................................ .. . ._ ._._......_ __.._._. ......_._..._...._._.. _.....___.___.._._._. FEES F; r FIHE=N D ROOD type amount by date r-ecpt 1 .-,-17-7!3 aW K I NEI GEORGE F',RM T' $ 25. 017r DEP OF,/ I 1 /98 ['\T NG C; , ! T hlr,, r;T TY r1R "•97,=_c:4 5PCT $ 1. P5 DFN 06/11 /98 KING (-,T7-"' F firine #: OWNER 26. S TOTAL RE OHTRF�D TNSPF:'rTTnNS This permit is isqued subj?ct to the regulations contained in the Gas I.A.r1e Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Meehan� - it Insp applirable laws. All work will be done in accordance with Fi r)al. L,i -pert i un approved clans. This permit will expire if work is not started within 190 days of issuance, or if work is suspended for more than 180 days. ATINTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-M--0010 through OAR 952-001-0080. You may cIttain copies of these rules or diract questions to OK by calling 'F�3)246-918 i. ' G'pr^m•i t�;ee Si nat�_�r•,a ���/��" J - . 4 1 ci_.. .... 4-++°4--4-.I-+4-++++4-+4-4-4-+-4-4-+-t...4-4++++++4-+4-+4.++++4+++-+-+++4.+-++++4-+++-+-+++++++++++++.+.+.+ Call. 639­41755 by 7:00 p. m. for- inspect i ons neer_ ed IJ-iW next; bl.)t, i nnss clay 1.44-++++++++4-+.+4,-+-4..+.1.+•i*-+-I-++++•++•+++++++.+.+•-r++-1-++++F+++++q 1 ++++•+ ++++++++++++4�. ) - -_._TI_IN-11-'98 THU 02: 12 ID: FqX NO: 5-OP I OFA CITY OF TIGARD Mechanical Permit Application Plan Check IMRecd By_ Z'T 13125 SW HALL BLVD. Commercial and Residential Date Recd L -t I r TIGARD, OR 97223 Date to P.E.-- (503) 639-4171, x304 Dare to DST.-4a - 4v- Print or Type Permit Incomplete or illegible-jpplications will not be acceptedCalled - ascription Table 1A Mechanical Code QTY PRICE AMT jot) Sicca:Adrliaes suite# A) Permit Fen --- .Q -0. 1000 Address a_ 1 V-) t cnyrstn zip 1.) Fumace to 100,000 FM- 9.00 12 including ducts&vents Pismo(or name,N wainlel�as) 2.) Furnace 100,000 STU. 7.50 own*.- �` '- ( �_ including ducts&vents Maung Ada 3.) Floor Fumaos - -- - 6.00 - r b�l�, 0 r _ including vent Gsyr9une ZIP Phono 4.) Suspended heater,well treater 11.00 to- Lr --c 0 JL &R 4-f Z3°) or floor mounted heater Nalinflni name rr rtiui,ose 9,) vent not Inciuded In appliance permit 3.00 a.y Occupant Mading'n�_ - A.) 6eibr or comp,heat pump,arc Band. 0 %. ( Y to 3 HP;absorb unit to 1001ir.BLFF- rryr ,ee Phone 7.) Boiler or camp,heat pump,av cond. 11.00 d0- -lC'i 01 3.15 HP;absorb unit to 500K BTLI" Cnntmetor Name 9.) Boiler or mmp,haat pump,air Gond. 1550-- 15-30 HP;absorb unlLS-1 mil STU- pnnr in prarmd maumg Address 9.) Dollar or camp,neat pump,air rend 22.50 asuance,a copy 3N.50 HP;absorb unk 1.1.75mil BTU- nr 1 Ilcsmees CayrArene 71P Phone 10.) l3nller nr camp,heart pa4Ttp,air mod 7, are required If X >50 HP;aWoM unit 1,75 mit BTU- e=pirad in COT Onaaon Can Coni.Borg lK,ll Fop•Oue- 11.) Air handling unit to 10,000 CFM 4.50 database Architect NaA1e 13.) Non-portable evaporate cooler 450 �di�dAddress -- `-� ----- - _ - or 14,) Vent fan connected to a wngle dura 3A0 Engineer CMf6rate Z y Phone 151 VenNlallon system not Included In a 50 r),•y,;nbn work Now O Addition O Alteration Repair O -1A) Herod Rnrved by mech9nical aYltauaf 4,50 !a tito done Remdentiel Q Non-roeidenti_al O jArt(iltlnnal Description of work: -� 17.) Domestic Incinerators 7.50 'rYt�'ftE.Q.�ri��dl+n P.G�cI-yr.4t-a''" '/►��`'.,"' _ __ __ �yLQa�J OQ 2J� 18.) Cnmmgraal er industrial type 3000 Inrinerator F=is.ring uxe or 19.) Repair units 4.50 t3wirring or property - 20) Wood stoves 4.30 Proposed use or �Q � �� 21 ) Clothes dryer,etc. 4 50 bulldinq or property __ T2- Uther units - - 4,50 Type of fuel oil 0 natural gas I-PC C Alartrir,0 23.) Gas piping rine to four outlets / u 2.00 I hert•.By srJcnowledge that I have read this application,coat the 24) Mor'than 4-per out),h(earn) 50 information grven is correct,that I am the owner or authorized agent of the owner,thait plans submMk?d ares in enmplianrx with Oregon State -J QTY.SUBTOTAL laws. Signature ofOwnerlAgenl --- Date - --� - "SUBTOTAL -CIO 5%SURCHAROE C."tact PFrson Name / _ hone v PLAN IiEVIFW 251A OF SUATOTAI �- " - --- 0 AL --- rrmrrhpmNevl d'c v 9 'Minimum permit fee iv a25*56/ %urchnrge "Residenflal A/C requires site plan chowmg placement of unit i U LU T Lu J O m Q ro U N v O W > O Z O a 0 NC� Z(, N -fit UQOi c N O d O Q Er C -C O O O� O m U w= 3 rd p 4� Q 0OW� Q E CL Z a1 Z z L i 2U OZ4 U pp pp ��pp Qp qq�� 'pIp co rn _O rn CO 00 m rn COQi Oi Q' CO� �i Oi Qi Qi gam) OOi Cl � N N rn N N O N N N N N C m co ao tx� co w co w ^ r, r` r• ro rn rn LO p O O O O a p -� = U -) = O p 2 Z m w w W W L7 O Q Q O p p Q W <n J r m a o m x° =J O Z N 07 N 0 i� z Z z rmi vii vi ccn v`ni —' m x v1i U)i z � Z (n w Z O cr 0 Y n Q a a d d LL d d d m cl 00 cn � m cp O O O n- Q O 0 U d � u) Q � F- E O C U o cL7 w cw7 E 3 cr 5 Q mita (AD, m o 0 ,Y N~ m 4 cp �p op aapp pp ap 0p popp cp N �p �p 0p Q �i O) Obi �i O> �i a A r ao w ao r`S 0 M a 4 4 4 c^ c%, cc c v er v N � N 7 7 r N N -N N ^ ^ w co ao m co co cb r` r- r- m � d O ~ rn o) c V ro U 4 x H v r c U ro o > a E to a U c n y c o [; ] N lT �� n n - n p N Q N c n a a v� 1 c c c_ c p o c d y C O C C LL'm C iz T U U C C f0 ) O CJI ro N U lT ro U O N 7 C CT O C .� C N 0) N C LL �' o w E y c D: 1^ cr E u n- Q n y L ro N V) O O O G N ttl -j N N t'np r) Ln L a U o. X Q tL w a w w cn C w m W '� LL. w c U A M t!) to O N O N In to O VU') to O N pp O) O N r+ M ') O O - O O f`7 47 O ON N N d to CJ) O co O) O O N O y t` O O r`O O O r- N N n r-- h- r- r` O O O O N G) >_ a a a a a a a a a a t a a a a a a a a a a. d a a r r F- r r r r r r r r r F r r F F F r r F- F- 6 m m to cn m to to v v) m U to o m to U cn cn cn v, cn m \ \ { k t E z e 2 + $ m $ m m $ # $ $ * $ $ m m S m $ $ * $ a { � a z z a 3 / a / % 4 ¥ / j CO p p R p p R ~ ° / p -j 5 § p p e p ) / 4 % � o e = = e = G / e = / � �> 7 )\ 0 z � CW) ƒ § 2 2 8 2 2 2 2 $ 7 k o « « < « < « « < « « a « < o o a IL a CL m (I Q- _ « M �L CL e � � m F- i ! a m \ \ m a 5 5 5 5 2 2 / P 2 ) d o / U 2 � ■ O)o \ cu J � � Q- 04 � o .> � � @ o / c [ U)L { 3 c } & > (L) IL ) s cu = 9 $ ` » / / \ G ` k y ) - ] g % ( \ 2@ § E m@ z g J E § 7 E f \ ) u 2 ( \ \ ' ` « ! \ ) � / ° « ! ) ƒ m a .: @ ) y % \ 2 c § 2 , 2 « \ < } \ } ) rr ) \ / } '. / & j / j 3 / \ w } 9 g in m o a m \ / J R °/ ® g \/ ? @/ ?K ° ^ - E§ @ G @} / / / / ) } 1.-./ } / / / \ K } }+ mmemm U) n m mU) § U) _ fj) V) n V) W m n n MASTER V.EnMIT iT 4 . . . . . MT CITY O F T I GARD rlM . . . ' 7 1_. , :Yf COMMUNITY DEVELOPMENT DEPARTMENT DATE 15C3LjED: 04/01 / 0c, 13125 SW Hell Blvd,Tlgurd,Oregon 9722398199 (503)639-4171 PARCEL • 10 cc i,73 7 TV!5 1 ON. 70,NING: ... . . . . . . . . . 11TION 235 90 FT PC-411 1 ....... FLOOR AFEAS---- DASE?M.., 0 if REGUAIFE ".; XKS-- REOUtAFED- - D' --''..:ADD K.I .......... 24 FIRST..... 2QZ if SPRAGGIC...... I sf L17T........... 5 M�r XTECTrS, 41? SECU...: e 5f Fq31T......... 20 PM!,C 7rrs! DWELLING ;SNITS: I FIN8507; 2 if RIGHT.......... 111m1 '7 ID", I DATP; t 235 3f VALUE..I- !!!T! REAR..........: --- PLUNBING ---------- 1X7,; S. t WASHING 2 LMRY TRAY'J.; 0 !LAIN DRAIN ft; 0 TRAPS......... M—.; 0 FLS" WINS— 0 2 D1;JWA41rL J StWER LINE ft, 2 SF RAIN DRAINS: I CATCH BA CC,a,I GARS M^wp., W9T'L7 1EATERS. 2 WATER LINE ft: I DCrTLW PREV14TP: e, qRCArr TRAPS'. O(WR rIXT!10r^ MMHANICAL --------- DC:L/DP ( AN e VCNT FWa..... 0 CLOTHES DKKS 4 2 'T11!! ''MATERS, , 0 Ms.. 2 OTTER UNITS...: 0 VM, ........... 2 wommn.... a GAS MMLETS—! ELC,-TRICAL ---TWP 3RV11F'=RC'-- - DPAOil C10JITS -NISCE' . :1 LESS: e 200 0 200 amp... e W/Svc OR Mp—. 1 201 400 2 201 414 amp..: I Ist W/o 14`V1^/rDR: 1 41" f 401 W 0 EA ADDL ZP Ca'P. L "P. 0 Z I'm alp. If I0004 amp/yflt.; ':k: Nrccrntct only. e )-zA PES UNITS.. 71)-= A.; i 600 V 1"INAL, MEMY rMDC I T'Ut,3. "77 "Via.7AGING C'UTDOOP, 011:1Z ........... ........... LAPAWAPE,'IRRIG: ..........I NSTRUPWATMN: minICAL........ 7 A.17LE CM.: NURSE CALLS....; TOTAL, FMIS:$ 234,31 -icns co,taire, in the Tigard Municipal Code, Statr of Ore, Specialty Code! and 811 rt0e, hith apprDVed This perrit will expire if work Is not started witlhi-, :har, 101 days, CcrtrO i fA -- • Residential Building Permit Application City of Tigard 13125 SW Hall Blvd. J/90 Tigard, OR 97223f p j7 ��r�� (503) 639-4171 / Jobsite Address: �o�') `r �? 16 L 7 (r t Lot/# Office Use Only Subdivision: ,Ji ^ k %f. Valuation: ^0 (3 Permit # �� V' Corner Lot? Y Reissue of Flag Lot? Y 11 Map & TL# Owner: ��%T1 �L�� M/�1��/S Approvals Required Address: /� '� �� `_�rl,) (_ ,L�GL= Planning Eigineering Phone: ��� �' C/r ` ` C� — Other Contractor: Items Required Address: � --- Subcontractors -- Truss Details _ Phone: - - - Other Contractor's License # _ (attach copy of current Oregon license) Contact Name & Phone: Subcontractors: Arch itectlEngIneer: _ --- Plurnting _ Address: Mechanical _ ---- (attach copy of current OR Conhactor's License) Phone: JOB DESCRIPTION. Applicant Signature & Phone number Received by: Date Received _--------_- ___—_-- — _ __� fPermit# Account Description Amount Amt. Pd. Bal. Due Bldg. Permit (BUILD) I Plumb. Permit (PLUMB) _ ech. Permit (MECH) CC Bldg: _ i' vi Plumb: Mech: Plan Check (PLANCK) � � _ C. <� Bldg: 7-5 Plumb: Mech: Sewer Connection (SWUSA) Sewer Inspection (SWINSP) Parks Dev Charge (PKSnC) _ Residential TIF (TIF-F.) _ Mass Transit TIF (TIF-kil') Commercial TIF (TIF-C) _ Industrial TIF (TIF-1) Institutional TIF (TIF-IS) Office TIF (TIF-O) _ Water Quality (WQUAL) Water Quantity (WQUANT) Fire Life Safety (FLS) Erosion Cntri Permit (ERPRMT) Erosion Planck/USA (ERPLAN) __— Erosion Planck/COT (EROSN) TOTALS: a�y -� - -= -44• e Permit#: L � Address: �Z7JZ� Sc,c? !`1 ( 4'��' C?Z°�'lYl N e Issued�.; by: �{�( �— Date: �.L� Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can he issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Dill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 313: 1. 1 owr, reside in, car will reside in the completed strw are. o ] 2. 1 understand that 1 must register as a construction contractor if the structure is sold or offered for sale before or upon completion. ❑ 3A. My general contractor is (Name) Contractor regis. # i will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR rr. r 3B. I will be my own general contractor. If I hire subcontractors, i will hire only subcontractors registered with the Construction Contractors Board. If i change my mind and hire a general contractor, i will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. 1 hereby certify that the above information is correct and that i have read and do understand the information Notice to Property Owners about Construction Responsibilitics on the reverse side of this form. (Signature of permit applicant) (bate) (White copy to issuing agency permit file, pink copy to applicant) Information Notice to Property Owners About Construction Responsibilities Note: This lgfortnation Nov, , !o Property Osr,r r.s about ('wistruction Responstbditic was developed by the Construe:;-, Contractors Board in accordance with ORS 701.050). if you are acting as your own contractor to cont tract a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware J the fell,Lwin€ responsibilities and areas of concern. EMPLOYER RESPONSIBILiTIE:S: If you hire persons not registered with the Consttuctton Cont ra%.:tors Board ti, do labor in constructing or assisting in the construction or improvement of a residential structure,you will, in most instant,­,he ruled to be an employer and the people You hire will be employees. As the employer,yot, must comply with the following: Oregon's withholding tax law: As an employer,you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax fmm your employees. For more information,call the Oregon Dept.of Revenue at 945-6091, Unemployment insurance tax: As an employer,you are required to pay a tax for unemployment insurance purpose.on the wages of all employees. For more information,call the Oregon t;.mployment Division at the Department of Human Resources at 378-3524. Workers'compen.+ation insurance: Asan employer,you are subject to the Oregon Workers'Compensation Law,and must obtain workers'compensation insurance for your employees. If yoti fail to obtain workers cornpenNat ion insurance,you may he subject to penalties and will be liable for all claim costs if one of your employees is injured on the it 6. For mope information, call the Workers'Compensation Division at the Department of Consumer and Business Services at 945-7898, U.S.Internal Revenue Service: As an employer,you must withhold federal income tax from employees'wages, You will be liable for the tax payment even if you didn't actually withhold the tax. For more information,call the internal Revenue.Service at 1-&M-9'29-1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for tl, ,.project,you are responsible for resolving any failure to nuct code requirements that may he brought to your attention through inspections. Liability and property damage insurance: Contact your insurance agent to see if you have adequateinsurance coverage,for ;1cc:idents and omissions such as falling tools,paint overspray, water damage from pipe;punctures, fire,or work that must be re-done. Time to supervise employees. Make sure you have sufficient time so supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor,to coordinate the work of rough-in and finish trades, and to nntify building officials at the appropriate times sn they can perfnrm the required inspc°ctinns. Ifyou have additional questions, write or call the Construction Contractors Board(PO Box 14140,Salem,OR 97309-5052, 503/378-4621). The board is located at 7(H)Summer St. NE Suite 300,in Salem. prop-t)wn.prn4 1194