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12685 SW KATHERINE ST
CITY OF TiGARD j-H tion t.i;:e: (503)639-417
BUILDING MST
INSPECTION DIVISiON Business Line: (503)639-4171 BUIP ----—
Received r Date Requested____--'__.
AM_ PM SUP p� —
�',�c._4 Ut" Suite MEL
Location — - - UCSD S O
Contact Person — _ Ph(_ ) PLM
Contractor _— Ph( ) SWR
BUILDING Tenant/ m r - b _7 ELC
Footing —� �J C 1 7 7`t ( H ELC _—
Foundation Access: IR _
Ftg Drain
Crawl Drain --Slab Inspection Notes. ,'P A&BeamShear Anchors �,
Ext Sheath/Shear ---
Int Sheath/Shear --
Framing -
Insulation
Drywall Nailing -
Firewall __ -_---- -
Fire Sprinkler - -- - — _
F're Alarm
Iusp'd Ceiling
RRoof
Other: /''� ` ✓�
Final - —C y�•r' /` _d—�—�-- ( 'd l ��� - -
PASS PART FAIL
PLUMBING _ _ -- J _�
Post&Beam7C
Under Slab - --
Rough-In
Water Service - -
Sanitary Sewer �L_Rain Drains }k` L,Cath Basin i Manhole
`� C---
Storm Drain
Shower Pan _ _ _ ---
Other:
Final � b��� --� •� �� -��
$S PART FAIL
ECH N ---
PostBgeam
Rough-In - -- .- --
Gas Line
Smoke Dampers - _----- -- - -- —
` QAS PART FAIL —
ELECTRICAL _ --
Ser6ce —
dough-tri t
I)G/Fiab
ILow',)Itage _�------- -----
La Alarm
Final l] Reinspection tea of$ __- - rMjLfl•nd befori next inspection Pay at City Hall, 13125 SW Hall Blvd.
PASS_ PART_ FAIL
81TE - Please call for reinspection RE:___. - _ Unable to inspect - no access
Fire Supply Lire l _ %
ADA intspe car- ___ Ext
Approacn/Sidewalk
Other. _
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
i
CITYOF TIGARD _ MECHANICA'_?ERM!T
IIT#: MEC2004-00088DEVELOPMENT 'ERVSES DATE ISSUED: 3/2/04
13125 SW Hall Blvd., Tigard, OR 97323 (503) 639-4171 PARCEL:
2 S 104AA-07900
SITE ADDRESS: 12685 SW KATHERINE ST
SUBDIVISION: BELLWOOD NO. 2 ZONING: R-4.5
BLOCK: LOT: 106 . URISDICTION: TIG
CLASS OF WORK: AI-T FLOOR FURN: EVAP COOLERS:
TYPE OF USE: S!= UNIT PEATERS: VENT FLANS:
OCCUPANCY GRP: N3 VENTS W/O APPL: VENT SYSTEMS:
STORIES. BOILERSICOMPRESSORS _ HOODS:
_ FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
i::AX INPUT: 3TrJ 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 .1- HP. CLO DRYERS
FURN < 100K BTU: 1 AIR HANDLING UNITS OTF,ER UNITS:
FURN -100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Remarks: Furnace rep'.acement.
Owner: --- _ FEES _ _ _--
RYAN. PAULA Description Date Amount
12685 SW KATHERINE ST 3/2 04 $72.50
TIGARD, OR 97223 IM[-('11] 1'crnui I cc
[TAN] 5"„ti;:nr 3/2/04 $5.80
Total $78.30
Phone: 503.590-1779 -- --
Contractor:
J,:,':OBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS_
Phone: 503-234-7331 Heating Unt Insp
Final Inspection
Reg #: LIC 1441
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore
Specialty Codes and all other applicable laws. All viork will be done in accordance with approved
plans. This permit will expire if work is not starter: within 180 days of issuance, or if work is si ispended
for more than 180 days ATTENTION Oregon law requires you to follow rules adopted in the Oregon
Utility Notification 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 by calling
(503)246-6699.
Issued By: ! . __..._ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mar -0 1 1 1 09 : OOF
P.02
Mechanical Pe rinit AimlicatioFOR OFFICE USE nRceciver',� Mechanical
EDat e/Ej j f / t ti Perndt No.:� _
Cit of Tigard V Planning Approval Dluilding
Y Datc/lL Permit No!
13125 SW Hall Slvd. M A 1 ) Plan Review Other
Tigard,Orcgon 97223 h1 `�O� Dated Permit Nu_ --
Phone: 503.639.4171 Fisi1T'30f3i Post-Review Land use
L� Date/By. Cue No.:
Internet: www.ciA&ard.ti}t*DING DivISIp ContACI —� lurts: See Put 2for
24-hour Inspection Rcquest: 503-6391117 Nan>c/Method: _ I SupplemenUl Inform.tion:
TYPE•OF WORK COMMERCIAJ:TrFt a SCNF.Di1LF.-USE CHFCKLISI'
U-Cw eoltstruction Demolition Mechanical permit fees'are bated on the total value of the work
❑ Addition/alteration/re)I,icertient Qther: pc6otmed. Indicate the value(rounded to lite neatest dollar)of all
- 1 Cocchi mical itiatcrials,equipment,!,ilius,overhead and profit
_ CA1`EGORY Ol+-CONS'1'ItUCT101V
2-r,amily dwelling Commercial/Industrial Value: s , _ See Patic 2 for Pee Schedule
Act cysnry Liuildin Multi Farnity 1tF.SIDF.NTIAL FQUII'MKKV8YVI'EMS FEE•SCHR_bULE
Descriptlun -�It Fee ea. Tutal
Master Builder Uthcr. ____ _ - ucatlit i:truun _
JOB SiT INFORMATION and LU". f l N r'umacc-mild-un air conditionln� 14.00
—T——
Job site ad_dress; Q;,neJ (gas near tp imp- _ 14.00
Suite sE; - i31dI;,/Aht.#; Duct work 14 tN)
Pr act Name: — - H dronic hot water,syntem _ 14,00
I(csidential boiler
Cross strcet/Directions to job Fite: for radiator or hydropic system) 14.00
Unit healers(fuel,not electric)
in wall,in-duct,suspended,rtc. _14.00
1.1!! vcnt for any of above) _ 1000
Subdivision: J_Lot!!; Repair units 12.15
other Fuel API pilantex
Tax n-Li / areel ll: water heater 10,00
adP-.T1 'O F ORK' C3as fireplace _ _ - _- 10.00 _--
Flue vent Lwater hem(er/p,ab tlropin:a) 10.00
-- 1 - La lighter ighter(as)- _ _ 10,00
v - - - Wuod/pellct stove — 10.00
-- _-- Wood fircplace/insert - 1000
IO
Other: 0. 0Chnney0�/ 1-- -
_
HTnE: -E;nvirnnmenol Exhaust&Venilladrin
tc
Address: Rmtge hood/ulher kihen ctiuipnir,nt _ 10,00
Clothes dryer exhaust 10.00
Cit /Sl1tC/L;r: ` Single Auer exhaust --
P le_ ''l Fax _ (bathrooms,toilet compartments,
PPI.1C T- _ rONTACA rh.ttSON - i� utili�nn.ruts) _ 6 RO
Nuc -( t_.� ��;_ i ,� ' Attic/crawl ce fans T_-4�-
II
Address: — Other: _ 10.00
' .t t 1 - Rucl i'ipinu
_City/Stale/Zi 1 l -i V"1 •e(S5.4t1 fur 11nt d,SI.IiIr each addillonai
P11011c: Fax_ _— rurnacc,ctr•. _ 60
- Gas heat pump _ •• _
E-mail: Wall/.sus craned/unit heater
CONTRA 1'0 Water heater _ -_ •• _. _
Business Name`y - c ) cc - t(r_�l fireplace
Address: `i._ .�`tz Rangy to _
rin ••
Cl
Crit /Blatt/7•ilr: 1 1�:1•. C�,_ i 1 .1 d _ �— ---.. _ _ _
Pham Others . -----__ .. �• —.
CCB Lic. #: Mcchaott ItPtrmlt P'ccs'
Authorized t — -- _
_ Subtotal: _S
Signature at J Minimum Pcrmit ree$72.50 S _
_Plan Review Fee 25%oof!'trout sec 5 P
(Please print nanlc) State Sumharite 11%of
Ty'I AL PERMIT F'EE S LJ `
Nvlfee: This permit application expires if a permit in nut out.tned within "Vee methodology ser by Tri-County ftildinq Industry Service Board.
Cao days after It has been-rrepted as complete. ••Sire pl-u r equlred for exterior Am"units.
UreaV'errnit FortnsVNrel'rnnu.^pp d w ulmi