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12515 SW KAREN ST
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CITY OF TIGARD BUILDING INSPECTION DIVIS10NJ""'-L_e,/7
24-Hour Inspection Line: 639-4175 Business Phone: 6394171 ��,e
Date Requested: A.M. P.M.—_ — MST:
(,oration: 2BUR
-L,5k 4-J
Suite: —Bldg: MEC:
Contractor: Phone: PLM: 00
Owner: UAAaA- ;
one: E"T,C-
.--- 112 Ire A2_1)Q .-J-61K
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BUILDING L ""t) MBIN ECC ANICAL_��) ZLECTRICAL SITE
Site Post/lien Ilo�s Sc3cam Cover/Service Sewer/Stonn
Footing Rrof, [Jndl,'I/Slab Rough-In 6d Ceiling Water Line
Slab Framing Top Out Gas Line RO -In I Ry Spi inkler
Foundation Insulation Sewer ecol"ect Vault
;, / CL
Bsmt Damp 1)"all Storin - L—,np St.—,ce MISC.
j I'
Mas,)niy Ceiling Rain Drain 0 YI RT Slab
Shcar/Sheath Fire SpkIr/AIrn Crawl/Found I)r I[cat Ptmll) i Low Volt
Approved
Approved Approved
Zr 71) T-It-J--"-1
Appr/SdwIk Not Approved NW-App ved NNott 1OVed Not Approved Not Approved
FINAL
AFINAL FINAL
W7+V
L/
C1('1111 tot reinspection n Reinspection fee of 3—,required helbre next inspection r"I I Jnnblt,to inspect
Inspec
tot: Date: of
C11Y OF T I CARD MECHAN I CAL
COMMUNITY DEVELOPMENT DEPARTMENT PERM IT
13125 SW Hall Blvd.Tigard,Oregon 97223e8199 (503)639-4171 PE R11 I T #. . . . . . . : MEC95-041r,
DATE IGGUED: 12/05/9-5
:ITE ADDRESS. . . : 12515 SW KAREN ST PARCEL-. 2S.104(m.-03600
;UBDIVICSION. . . . : BELLWOOD
J ZONING: R- 4. 5
0
c... . . . . LOT. . . . . . . . . . . . . :,3o
CLASS OF WORK. . :NEW FLOOR FURN. . . . : 0 EVAID COOLERS: 0
TYPE OF USE. . . . :SF UHTT HEATERS. . : Q1 VENT FANS. . . : 0
OCCUPANCY GRP. . :A I V'_NTS 14/0 APPL- 171 VENT SYG3TEMS: 17.1
STORIES. . . . . . . . : 0 OILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL 0• 3 Hp's. . . . Vi DOMES. INCIN: 0
:/GAS/ HF'. . . . : 0 COMML. INCIN: 0
MAX INPUT a 0 BTU 1'5- 3 0 HP. . . . 0 REPAIR UNITS: 0
1 IRE DAMPERS% . 30-50 Hp,. . . . s 0 WOODSTOVES. . : 0
,AS PRESSURE. . . 50+ HP. . . . - 11 CLO DRYERF`). . - V)
NO. OF UNI*TS----.---.--,.-- AIR HANDLING UNITS OTHER UNITS. : 0
17URN ( 100V I)TU- ! (= 1011100 (--fill: it GAS OUTLETS. .- 0
FURN ) =1121121K BTU: 0 ) 10000 cfm: 0
Remarks : Irlst -,411 new cat't^ier- gas Fl_tt-nam-e.
Uwner"; •_._.___....__._________________._.__________ FEES
ART MARTINEZ tvpe amol.mt by dat;.-2 t-ecpt
12515 SW KAREN PRMT $ 25. 00 TMP 12/1245/95 95--27352E'
TIGARD OR 972113 FSPCT $ 1. E'5 TMP 12/05/95) 9527352�
Phone #:
#:
126. 25 'TOTAL
REQUIRED INSPECTIONS
-is pewit is issuer' subject
;ect to the regulations contained in the Gas Line Insp
,card Municipal Code, State of Ore. Specialty Codes and all other 111eCJlSni(-_.A1 Insp
Tolicable laws. All work will be done in accordance with Misc. Insper-,tion
i,.croved plans. This peroit will expire if work is not started Final Inspectiun
.i.hin 180 lays of issuance, or if work is susoended for oore
than 180 days.
e r m i t t;e e S i 13 11 A t 1.1 t-P e 'tJ1,00 14 E>
i:. st-ted By : .......
1 for ills0e(--t i on 6:,9-417,
City of Tigard MECHANICAL PERMIT Planck/Rec. # 35
13125 sw Halt Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
-
L�esrnpuon
°C Table 3A Mechanical Code QTY PRICE AMT
Job 1 a�>���^ 1) Permit Fee -0- -0• r t0.00
Address r°
�.� 2) Supplemental Permit 3.00
BTU
16A 1) incl. duds 8 vents
i
urnaca IG0,000 STU +
i✓vmP.r -�G J. 2) incl. ducts 3 vents
loor urnance
3) incl. vent
Suspended heater,wall heater
4) or floor mounted heater 6.00
int rk.t in .in
Occupant 5) appliance permit
79epair of healing, retng.
6) cooling,absorption unit 600
nilor or comp, heat pump, air cond.
7) to 3 HP absorp unit to 100K 87U 600
Boiler or camp, heat pump. air Gond.
6) 3-is HP absorp unit to 5C01< 87U 11.00
Contactor ,, ciler or comp, heat pump a
9) 15-3i1 HP abscrp unit.5.1 mil BTU 15 CO
moiler or comp, heat pump, air ccnd.
1�) 30-50 HP absorp unit 1-1.75 mil BTU 22,5x1
hereby acknowledge ad this application,that he ?r or comp, hoat pump, air cond.
information given is correct, that I am the owner or author,.ed agent I 11) > So HP abscrp unit 1.75 mil B'rU 31.Si1
of the owner, that plans submitted are in compliance with State ) Air handling a it to —
la'vs,that I am regis;e"ed with the Construction Contractors Scard, 12) 10,000 CFM 4 CO
that the number given is correct. (If exempt from State registratfo,i, Air handling unit -
ple„sa give reason below.) 13) 10,000 CTM + 750
Non portable
14) evaporate cooler 4,50
ant tan connected
15) to a single dud 3.00
Ventilation system nct - -�
1 ii) included in appliance permit 4.50
Hcod sere t,y
1;ii mechanical exhaust 4,50
Describe work naw addition tJ alteration repair Commercial or industrial -
to be done residential non-residential Q 18
type inr',?rotor 30.00
Existing usa� i.e.,w stove,water
buikfing or property 19) he<ter,solar,clothes dryers,etc. 4.50
Proposed use of 20) (.as piping one to four outlets 2.00
building or property -- --
TypF�of fuel •of Q natural gas LPG 0electric Q 21) More than 4-per outfit —
-
NOiIC � T--
Mir.iinurri Fa? I I .�L
PERMITS BECOME VOID IF WORK C,R CONSTRUCTION 325.00 SUBTOTAL
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SU'!PENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED. -- --
TOTAL _A.o.
Special Conditions -�- l 5�f.,1 [�� Y`( (?l, —
G 'L1.1(-RC1 i Date issued /l, S �S by
tw6dwrr
CITY OF TIGARD OLUMBING iPERMIT #. . . . . . .PERMll
: PLM960011
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 08/06/96
13125 SW Hall Blvd.Tigard,Oregon 97223*8199 (503)1139.4171 PARCEL: 2S104AA-03600
SITZ 1. AUL)RES6. . . : I2515 SW KAREN ST
SUBDIVIFION. . . . : BELLWOOD ZONING: R-4. 5
BLOCK. . . . . . . . . . . LO1.. . . . . . . . . . . . . :30
LLASS OF WORT-%. . :AL'T GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :A1 FLOOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . . it)
STOPIES. . . . . . . . . 0 WATER HEATERS. . . . . : I CATCH BASINS. . . . . . . : 0
LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . it)
SIN: 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . 0
LAO 0 OTHER FIXTURE=S. . . . : 0
TUB/Si JI- 'c:RS. 0 SEWER LINE (ft ) . . . 0
WATER CLOS'-'TS. 0 WATF'_R LINE (ft ) . . . 0
D I SHWASHr!QS. . . . 0 RAIN DRAIN (ft ) . . . 0
Remarks , Install new water heAter,.
Owner-: FEES
ART MARTINEZ type arnot-trit by date r-ecr)t
1A_'515 SW KAREN PRMT $ L5. 00 .' SD 1211/0'4/96 96-275262
5PCT $ 1. 25 Jt�T) 1211/2'4/96 96--;_'7,3262
TIGARD OR 97223
Phone #:
Coritt-actori
KODIAK PLUMBING
6604 SE WOODSTOCK
PORI LAND OR 97206
Phone #: 318-9098 MBL $ 26. : 5 TOTAL
Reg #. . : 72465
REQUIRLED INSPECTIONS
This permit is issued subJect to the regulations contained in the Misr. Insp ction
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspectior,
applicabli., rws. All work will be done in accordance with
approve plans. This permit will empire if work is not started
within 180 dayF of issuance, or if work is suspended for more
than 180 days.
Pet-mittee Signatl.tv-e
Issi.ted By. ........ k4w Nor f>05rtx)
Call for, inspection 639-4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # _
13125 SW Hall Blvd. Permit #
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
/1 IJ t ✓AG� 1Z I i�Fc'7'�r NowSinalo Family Resiuences Only
Job 's_ / `� lj (�). �� �� 13 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
❑ 3 BATH HOUSE$2:5.00
Address C•n311r. nr Fee includes all plumbing fixtures in the dwelling and the first 100 feet
97Z of water service, sanitary sewer and storm sewer. See fees below.
FIXTURES CITY PRICE AMT
Sink 9.00
FI— Lavatory _ 9.00
Owner �� " �G Tub or''ub/Shower Comb. 9.00
�"'w•
zip Shower Only 9,00
Water Closet 9.00
Dishwasher 9.00
Garbage Disposal 9.00
Occupant wrq Ad&— Washing Machine 9.00
Floor Drain
_ 9.00
A' Water Heater 900
M Laundry Room Tray _ 9.00
"•"• j nUrinal 9.00
t/ �( `?/,,rte 4, l Other Fixtures (Specify) 9.00
w.rp Am... ' Pn -- —--
Contractor �) 9.00
9.00
• m _ 9.00
' 7
Sewer 1st 100' 30.00
/ °G'" Sewer -!a. AddiL 100' 25.00
_ 7 ! _ r 'y�� c�CD y�/��' Water Service 1st 100' 30.00
I here- acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the uwner or authorized agent of
the owner, that plans submitted are in compliance with State laws, tl�at Storm &Rain Drain 1st 100' 30.00
I am registered with the Construction Contractcr's Board, that the Stone Rain Dmin Addft. 100' 28,00
number given is c;o act. (If exempt from State registration, please
give re son below I Mobile Horne Space 25.00
y- 7 Back Flow Prevention
z �� Uevice or Anti-Pollution Crevice 900
—� �- '•0'"�
ON. Any Trap or Waste Not
Connected to a Fixture 9,00
Descnbe work new Q addition 7—alteration A repair O Catch Basin
to be done residential 9.00
7 non-resit+ential (�- Insp. of Exist. Plumoin9 AUAO/hr
Specially Requested Inspections 40.00/hr
Existing use of ez
building or property
��'S -t e' Rain Drain, single family dwelling 30.00
_ Residential backflow prevention
devices 15.00
Plcpased use of -~-
budding or property _
'(Except residential backflow
prevention de rices)
NOTICE 'Minimum Fee $25 00 SUBTOTAL 7
PERMITS BECOME VOID IF WORK OR CCNSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 59:SURCHARGE 1,t
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS Al ANY TIME AFTER WORK IS
COMMENCED. PLAN REVIEW 25% OF SUBTOTAL
�,//
Special ConditionsSTOTAL
dtT,e,� (117h�L,L.tt��U�7{f n�
Date issued _ I7 ��i --by—�J/26
CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
KODIAK PLUMBING
6604 SE WOODSTOCK
POR'rLANL OR 97206
Plumbing Signature Forto
Permit # . . . . : PLM96-0011
Date Issued. : 04/16/96
Parcel . . . . . . : 2S104AA-03600
Site Address : 12515 Sin] KAREN ST
Subdivision. : BELLWOOD
Block . . . . . . . . Lai . 30
Zoning. . . . . . : R-4 . 5
Remarks :
Install new water heater.
Your company has been indicated as the plumbing contractor for the permit indicated above. In order
for the plumb;ng permit to be valid, please have the appropriate individual from your company sign
below and re'.urn this Plumbing Signature Form prior to the start of work. No plumbing inspections
will be authorized until this completed torm is received.
AN INK SIGNATURE IS REQUIRED ON THIS FORM
PILDMB I NC, CONTRACTOR :
ART MARTINEZ KODIAK PLUMBING
12515 SW KAREN 6604 SE WOODSTOCK
TIGARD OR 97223 PORTLAND OR 97206
Phone # Phone # :
Recd # . . : 72465
7tx J,
Signature of Authorized Plumber
Please return this completed form to the address above.
ATTN: Building Dept.
If you have any questions, please call 639-4171 , ext. #3'10