12745 SW KATHERINE STREET N
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go I 06n CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
DAte Rquested A.M. P.M. MST:
Location:
e , BUR
Tenant: Suite: Bldg: MEC
L7,
Contractor: ,' ��one: PLM:
Owner. Phone: 7 EIX:
E1,R:
SIT:
BUtLDVIG BLDG(con't) PUMBING
EUCTRICAL SITE
Site "ost/Bee st/licam -7o-.WiTe—am Cover/Service Sewer/Storm
Footing R(x)f I Jndl,'I/S!db Rough-In Ceiling Water Line
Slab Framing Top Out 7W.57-L—H Rough-In UG Sprinkler
Foundation Insulation Sewer I lotxVDti t Reconnect V.1ult
Bsint Damp Dqyval! Storm Temp Service MISC.
Masonry Ceiling Rain Drain ----7VC- UG)Slab
Sheaf/Sheath Fire SpkIr/,XIm Cra,-.VI`ound Dr I feat Pump Low Volt
Approved Approved 0%. Approved Approved
Appr/Sdwlk Not Approved Not Approved 'rroved Not Approved Not Approved
FINAL FINAL N FINAL FINAL
0 Call for reinspection 0 Reinspection fee of required Wbre next inspection M Unable to inspect
Inspector: Date: page—of
CITY OF TMECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hell Blvd., Tigard, OR 97223 (503)639.4171 PERMIT #. . . . . . . : MEC97--0478
DATE ]ISSUED: 1L::-'/1.9/97
Pf1RCEL: 29104AA-O'7400
S T TE ADDRES35. . . . 12745 S14 KATHERINE ST
��UHD I V I S I ON. , . . : BELLWOOD NO. 2 ZON i Nu: R•-':. a
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : .11. 1. JURISDICTION: TIG
CLASS OF WORE',. . :AL..T FI-OOR FURN. . . . : 0 EVAP I-OOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS.. . . : O
OI'..CUPANCY GRP. . : R3 VENTS W/O APPI._: 0 VENT SYSTEMS: 0
SFOR I=:S. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUS I__ I YPES------------- 0-3 HP. . . . : 0 DOS ;75. I NC I N. 0
:LPH 3-15 HP. . . . : 0 COMML. INC1N: 0
MAX INPUT: 0 PTU 15--3O HP. . . . : 0 REPAIR UNITS: 0
F-T RE DAMPERS ). . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GrrS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
'40. OF UNITS-••---- ___.____ AIR HANDLING UNITS OTHER UNITS. : 1
FURN ( 100K BTU: 1 (- 10000 cfm: 0 GAS OUTLETS. : 1
FURN ) -1.0OK PTU: O > 10000 cfm : 0
Ren.--+r-1<s : Installation of furnace and gas piping.
Owner; - -_____.___._____._ -____._________.__....____.-___-___-_-_.- _ FEES
TOM WALPOLE type 4mount by date r-ecpt
12745 SW KATHERINE PRMT $ 25. 00 TJH 12/09/97 97-301568
TIGARD OR 97224 5PCT $ 1. 25 5 TJH 12/09/97 '37-301568
F'hnne #:
-orrtractor:
Mf; FURNA-E I-IFAT1NG INC
16.:'65 SW 85TH AVE -•------._____.______ _.__________-___ _--
$ 26. 25 TOTAL
T T CARD OR
Phone #: 684--901.4
Reel #. . : OOOP79
-- -- - REOU I RED INSPECTIONS
this paroit is Issued subject to the regulatrnns contained in the fIas l_.in$: Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Meehan i r Fk1 Ins p
applicable laws. All Mork will be done in atcnrdance t0l,. Heat inq Unt Insp _ _ �-
approved plans. This permit will expire if Mork is not started Heating Unt Insp
within 100 days of issuance, or if isork is suspended for more Final I n s pect i nn _ __•� ___ _ __ _
than 160 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules Aro
set forth in OAR 952--001--0810 through ORR 952-081-@868. You may
obtain copies of these rules or direct questions to OUNC by calling
(5031245-9167.
Issr.tE P �f ``'� ��f ► ermittte Si grnatue
++++++++4++++++++++f++A-+++•M+++++++++++++++++++++++++1-+++++++++-h+++4 +++++++++-( ++
C,:ll. 639-4175 by 7:00 p. m. far inspections needed the next business clay
i-4•+++•1-++++.+++++*+++++-1-++++++++++++++++++++++++++4.+++++++++++++++++++4-+++++4+++-
Plan Check#
CITY OF TIGARD
Mechanical Permit Application Reed By
13125 5W HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97213 Date to P.E. _
(503) 639-4171, x304 Date to DST
Print or Type Permit r� ?
Incomplete or illeible applications will not be accepted Called_
Nerve of Devaeopmenwro)ecl Description r
Table 1A Mechanical Code QTY PRICE AAT�
.lob Street Address $Odea A) Permit Fee0- 0 10.00
Address 77j.5 cul K3�rik)(
emgAt C stns zip 1.) Fumaue to 100,000 BTU 6.00
CJ 72 Z including ducts&vents (L,
Name(or name of business) 2.) Furnace 100,000 BTU+ 750
Owner Yl co o t',-)ti - incluaing ducts&vents
Mailing Address 3.) Floor Furnace 6.00
7`L .SLS kr 4 -,N including vent
City/State zip Phone 4.) Suspended heater,wall heater
)rQ ��7? I t) 7` or floor mounted heater 6.00
Ne (or narne of business) 5) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp,heat pump,air Gond. , 8.00
to 3 HP;absorb unit to 100K BUT-
cityrstne Zlp Phone 7.) Boiler or camp,heat pump,air cond. 11.00
_ 3-15 HP;absorb unit to 5UOK BTU"
t' ,ntractor Name -- 8) Boiler or comp,heat pump,air Gond 15.00
15.30 HP;jbsorb urit.5-1 mil BTU"
Prior to permit Mailing Address 9.) Boiler or comp,heat pump,air Gond. 27..50
issuance,a copy Z 'i -w - ��. _ Z 30-30 HP;absorb unit 1-1.75mil BTU"
of all licenses t'?q(state Zip Phone 10.) Boiler or comp,heat pump,air rand. 37 5u
are required H _ d '50 HP;absorb unit 1.75 mil BTI;"
expired in COT Con .Cord.Bosrd Lk.M Exp,Dste 11.) Air handling unit to 10,000 CFM 4.50
database 79G,
Architect Name "
13.) Non-portable evaporate cooler 4,50
Or Marling Address 14.) v int fan connected to a single duct 100 T_
Engineer cnWStne Zip Phone 15) Ventilation system not included in 4,50
i�__ _appliance permit
Describe work New O Addition O Alteration O Repair O 16.) Hood served by mechar-cal exhaust 4.54
to be done Residenthl_O Non-residential O _
Additional Description of work: 17.) Domestic incinerators �i 7.50
18) Commercial or in
type 3000
Incinerator
Existing use of �� 19.) Repair unds _ A 50 A-
building or property
20) Wood stove 4.50
Proposed use of 21.) Clothes drytr,etc. 4.50
Wilding or property ^-
22) Other units 450
Tvpe of' )I-oil O natural gas LPG O electric O - 2.3) Gas piping one to four outlet: 200
Ihereby acknowledo that I have read this application,that the 24.) More than 4-per outlets(e.,i) 5C
information given is cured,that 1 am the owner or authorized agent of
the owner,that pans submitted are iW,mpliance with Oregon State A QTY.SUBTOTAL.
laws.
SI Hato OwnertA nl 1 -� 5 r -
9 Date *SUBTOTAL
kk :,%SURCHARGE I 1
Contact Person(tame Phone PIAN REVIEW 25%OF SUBTOTAL
--- - - TOTAL
t Vrechpmt doc (rev 9 --
'Minimum permit fee is$25+5%surcharge
"Residential A/C reryuires site plan showing placement of un,,:.