9185 SW 69TH AVENUE i
ADDRESS:
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CITY OF TIGARD BUILDING IMPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
�-y
Date Requested: `1 — ! _ A.M. ,a " -P.M. MST:
Location: d r�T,( ' _1 Tom' BUP:_
Tenant:_ Suite: Bldg: MEC: �?-03-3
Contractor: Phone: 7( PLM:
Owner:_ Phone: ELC:
P Ci EY M QE-W- ELR:
�ti ,.� aE MADC- SIT: _
BUILDING BLDG(con't) PLUMBINGCHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Pos e - Cover/Service Sewer/Storm
Footing Roof UndFUSlab Rough-In Ceiling Water Line
Slab Framing Top Out 9 s me Rough-In UG Sprinkler
Foundation Insulation Sewer )uct Reconnect Vault
Bsmt Damp Drywall Storm furnace Temp Service misc.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/AIm Crawl/Found Dr Heat P5ttuk Low Volt
Approved Approvedove Approved Approved
,AMAppr/Sdwlk Not Approved Not Approved roved Not Approved Not Approved
FINAL FINAL 96 Ft1NAL FINAL FINAL
Q1
C.0
J
O Call for reinspection &tJ
Reinspection fee of S rey�iredlbere next inspection 0 Unable to inspect
Inspector: � Date. 1 Pege _of
CITY QF TIGARD MECHANICAL
DEVEL.r PME(VT SERVICES PERMIT
PERMIT #. . . . . . . MEC97— JJrI
1312.5 SW Hall Blvd., Tigard,OR 97223 (503)639.1171 DATE ISSUED: �'t9/05/97
PARCEL; 1 S 1 25DA-0-;800
SITE ADDRESS. . . : 09181 SW 69TH AVE
SUBDIVISION. . . . : ICINGS VIEW ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :75 JURISDICTION: TIG
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANC`' GRP. . : R3 VCNTS W/O ADPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . ,. . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES------------ 0-3 HP. . . . : 'r DOMES. INCIN: 0
:GA X 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS''. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF L1N I TS--- - - ----- AIR HANDLING UNITE. OTHER UNITS. : 0
TORN ( 100K BTU: 1 (= 10000 cfm : 0 GAS OUTLETS. : 1
FURN i =1O0K BTU: 0 > 10000 cfm : 0
Remarks : Converting from oil to gas furnace
Owner: -------------------------------------------------------- F=EES ---------------
DON WALLACE type amount by date r-ecpt
9185 SW 69TH PRM-i $ 25. 00 B 09/05/97 97-298982
TIGORD OR 97223 SPCT' $ 1. 25 B 09/05/97 97-29898E,
Phone #:
Cont r-act or,:
SOUTHWEST SHEET METAL
10A15 3W 72ND ------------------------------------
26. 25
-----------------------------------
26. 25 TOTA!,
PORTLAND OR 97223
Phone #: 503-246-6284
Reg #. . : 000450
REOU I RED INSPECTIONS -------
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mi sc. Inspection
applicable laws. All Mork 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 more
than 180 days. ATTENTION: '•egon law requirrs you to follow rules
adopted by the Oregon Uf tty Natification Center. Those rules are
set forth in OAR 9524` 1-0010 through OAR 952-001-0080. Yo,l may
obtain copies of these rules or direct questions to OX by calling
(503)246-9187.
TsS�,e By : v ' Z � _-�� Permittee Signatl_tr•e
++++++++++++++. ++++-t`+++++++i++++++++++++++++++++++++++++++++++++++++++++++++++4
Call 639-4175 by 6:00 p. m. for inspections needed the next bltsiness day
++++++++++++++++++++++++++++++ r•++++++++++++++++++-F+++++++++++++++++++•F++++++++�
Plan Check#
CITY OF TIGARD Mechanical Permit Application Recd By •r
13125 SW HALL BLVD. Commercial and Residential Date Recd 11Z
TIGARD, OR 97223 Date to P E.
(503) 639-4171, x304 Date to DST
; �3 3
Print Or Type Permit#Called
Incomplete or illegible applications will not be accepted
r__11
ofDeveopmenUProie(Y Description
Table 1A Mechanical Code OTY PRICE Ow
Jot StreetAdtgr. Suites A) Permit Fee -0- -0- 10.00
AdJress
Bidga Crtyistate Zip 1.) Furnace to 100,000 BTU 6.00
including ducts&vents
Name(or name business) r
2) Furnace 100.000 BTU+ 7,50
Owner t Ct I 6( Y_ / including duds&vents
Mar�pp Adgreas 3.) Floor Furnace 6.00
t S �t � including vent _
C ` late Zip Phone 4.) Suspended heater,wall heater 6.00
&)%1 722_j or floor mounted heater _
Name( non»of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Addrou 6.) Boiler or comp,heat pump,air Gond. 6.00
to 3 HP:absorb unit to 100K BUT" _
Cayistale ZIP Tphonts 7.) Boiler or comp,heat pump,air Gond. 11.00
3-15 HP;absoro unit to 500K BTU"
Contractor Name _ n 8.) Boder or comp,heat pump,air Gond 15.00
(Prior to 00 )\w'��l � � 15-30 HP;absorb und.5-1 mil BTU"
issuance Matting Address 9) Boiler or comp,Meat pump,air Gond. 22 50
applicant l S, '7'L 30-50 HP.absorb unit 1-1.75mil BTU"
must provide allcrt�rsuIe y Zip phone 10.) Boiler or comp,heat pump,air Gond. 37,50
contractor tC �)7 J 7T l 3 1`�l r,� `� >50 HP,absorb unit 1.75 mil BTU'"
license Oregon Const Cont.Board Lic a Exp Date 11 ) Air handling unit to 10,000 CFM 4.50
information if _ L r�
expired in T /
COT COT Business Tax or Metro a Exp Dare IV-
12.) Air handling unit 10,000 CFM 7,50
database) I I ii6
Architect Name :3) Non-portable evaporate rboler 4.50
or I
Mailing Address `^ 14) Vent fan connected to a single dud! 3.00
Engineer C tyrstate Ztp Phone 15) Ventilation system not included in 4.50
appliance permit
Descnbe work New O Addition O Alteration O Repair O 16) Hood served by mechanical exhaust 4.50
to be done Residential O Non-residential O _
Additional Description of work 17.) Domestic incinerators 7.50
;-t 18) Commercial or industnal type 30.00
Incinerator
Lxisting use of J 19) Repair units 4 50
building or property le 4,
20) Wood stove 4.50
Proposed use of 21 ) Clothes dryer,etc 4 50
building or property
22) Other units 4.50
T e nate ga G O electric O 13) Gas piping one to four outlets 2 00 (_)
t- I hereby acknowledge that I have read this application,that the 24) More than 4-per outlets(each) 50
information given is correct,that!am the owner or authorized agent of
the owner,that plans submitted are in complianco with Oregon State QTY SUBTOTAccL
laws _
Signature of Owner/Agent / / `Date 'SUBTOTAL
r`
1 )tt l
` LLLsss/ G ' 5%SURCHARGE
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
TOTAL
i'+dstVnechpmt.doc (rev 9 Minimum permit fee is S25+5%surcharge LIG
"Residential A!C requires site plan showing placement of unit
CITY OF TIGARD IYIECHANICAL
DEVELOPMENT SERVICES F,ERM I T
13725 SW Hall Blvd., Tighrd,OR 97223 (503)639-4171 P.,ERMIT it. . . . . . . : IYIFC96--0401
DATE ISSUED: 11 /18/96
F"ARCEL: ISIC".5DA-07600
SITE HDDRE'33S. 0918'J SW 6-'3TH AVE
SUBD I V I S T ON. . . . KINGS VIEW ZONING. R.-4. 5
BLOCK. . . LOT. . . . . . . . . . . . . :75
C,LASS OF7- WORK.. -ALT FLUOR FURN. . . . , 0 EVAP, COOLERS: 0
TYPE OF:' USE. . . . SF UNIT HEATERS. . : CA VENT FANS. . . : 0
OCCUPANCY GRP,. . : R3 VENTS W/O Al-'P'I-: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : BOILERS/COMP,RESSORS HOODS. . . . . . . : 0
FUEL 0--74 HPI. . . . 0 DO11ES. INCTN.- 0
: /WOO/ 3-15 HF,. . . . 0 COMML. INCIN: 0
1y1AX INPIUT: 0 BTU 15. 310 1-1 F.,. . . . 0 R171-AIR UNII'S: 0
F T RE DAMPERS". . : 30- 50 HP. . . . 0 WOODSTOVE'S. . : I
GAS r-,RESSURE. . . j04- HF,. . . . V.1 C1-.O DRYE=RS. . : 0
NO. OF AIR HANDLING UN I TS OTHER UNITS. : 0
FU13N ( 100K BTU: 0 (= 1,0000 C-fin . 0 GAS OUTLETS. : 0
F'URN ) =100K BTU. 0 > 10000 cfm : 0
Remarks : I nst,-il 1 ing a gas insert -fireplace
Owner,: FEES
DON WALLACE type z.A in o i.t n t lay date )-'er-pt
9185 SW 69TH F,RMT $ 25. 00 B 11/18/961 96--286651
1:7 -1
5P'CT $ 1. 25 B 1. 1/18/9(--1 9 6 86,65 t
TIGARD OR 97223
P'Ihione #:
Contt-actot,:
0 W N R
1=,h u n(7, #: $ 26. 25 TOTAL
Rey it. . : 1,"1125
REQUIRED INSPIECTION's
This pewit is issued suoject to the regulations contained ii the Woodstove Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final. Inspection
applicable laws. All work will be done in accordance with
approved plan,. This perilt will expire if work is r5t ste ted
-iithin 180 days of issuance, or if work is suspended for vore
than IN days.
(VWV\at� VV
Issued By .
1 for inspect ion 639-4175
Plan Check it
CITY OF TIGARD Mechanical Permit Application Rec'dBy-?, �
13125 SW HALL BLVD. Commercial and Residential Date Reca I I- I`6-�1 to
TIGARD, OR 97223 Date to P E.
(503) 639-4171, x304 Date to DST
Permit At fi`a y C Q I
Print or Type
Incomplete or illegible applications will not be accepted Called
NaTe OfDfv�prcr,vProf— Descnpbon
/I /1W . - Table 1A Mechanical Codo aTY PRICF + AMT
Job streetAddms 7'r r Suses _
A) Fem,a Fee -0- fJ- 10.00
Address y Sly
Bldg& Cgy, uqe LP (3) Supplemental f-e,mit 300
Nrne tar neer»d busawasl 1.) Furnace to 100.000 BTU 6.00
Owner ���, ind.ducts b vents
MA" Y 2.) Fum.ace 100,000 BTU« 7.50
�" -� �L✓ ; ind.ducts b vents _
CaW Zlp 4
'7., �.!- 3.) Floor Fumacs 6.00 --
L �a ! ind.vent
Narnqfwnrneof busslrsa) 4.) Suspended heater,wad treater 6.00
or floor mounted heater
Occupant Ma"^°O'a" 5.) Vent not ind.in 300
appliance permit_
C�yr�7aes LP Phone 6.) Boiier or uxnp,heat pump,arc Cord. 6.00
to 3 HP:absop Lind to 100K BTU
~-� NarTe 7 Boiler�v comp,heat u
) pump.au Coad. 1 1.00
3-15 HP;absorp unit to 500K BTU
Contractor A°a'ss 8.) Baler or cmV.heat pump,au writ. 15.00
15-30 HP,absorp and.5-1 nit BTU
Anach copy oft:ry Pl ane 9.) Boiler or co np,heat prmip,air cow, 2250
Current Licenses / /_ i i r1 J S y.5 y I 30-50 HP:absorp unit 1-1.75 and BTU _
Of.gen Const Corn.Board u,c s env Ome 10.) Boder or comp,haat pump,au rxind. 37.50
>50 HP:absorp unit 1.75 and BTU
COT Bustwu Tan or M&M s EAP Das 11.) Air handling unit to 4.50
10,000 CFM
Architect Name 12.) Air handling unit 7.50
10,000 CTM 4.
1 or Ms'f"g A°0ra's 13) Nim portathle 450
evaporate cooter
Engineer Ctyrsurre Lp Pnona 14) Ver:is ;onm;ted 300
_ to a Ie duct
1
Describe worts New O Addition O A lerabon O Repair O 15) Ventllabon system not 450
!_to be done Residential O Non residential O inducted in appliance permit
Additronal Cescnption of work 16) Hood served by
mechanical exhaust 450
17) Domestic incmeratom 750
Exts"use of —� 18.) Commerual or industrial i 30 DO
! 5uddrq or property _T h/pe incinerator
19) Clothes dryers,etc- 4 KO
Proocsed use of 20) Other units - 4 50
`� I bwldrr 9 or property
Type of�uef•of O natural gas O LPG O electric O 21) Gas piping one to four outlets 200
J I homey"nowtedge that I have rea(]this app x;ation,that the 22) More than 4-per outlet (each) 50
�. enhxrnafror given is correct that I am the owner or authnrtzed agent of
c4 iw owner that plans submitted are in compliance with Oregon Stare
4TY.SUBTOTAL
'aws
-a Signature 6f Owner/Agent Date 'SUBTOTAL r�
'zzz tll* 5%SURCHARGE 1
Cog erson Name hone PLAN REVIEW 25%CF SUBTOTAL
TOTAL 1241t,
dstvnewormtdoc 'Minimum permit fee is S25+5%surcharge
ev 7196
VCITYOF Ti�.�RD MECHANICAL
Two F.,F RN IT
COMMUNITY DEVELOPMENT DEPARTMENT "�"M I T #. . . . . . . . MEC91-01
13125 SW HWI Blvd. P.O.Sm 23397,TlgeM,OrsW 97223(603)6394176 T—_7
!T 6-1 t!E LD; 0 c.i11
5 09 165 SW 69TH PARCEL: IS185DA-07:7t,71i"
-:"J B 1)1 1)152 11)N, I 1'.i S V I U W ZONING: R-4- 5
SLOUR. . . . . . . . . . Lo"r. . . w . . . . . . . . . .75
i,LASS OF WORK. . :ALT FLOOR FURN. . . . . EVAP COOLERS:
TYPE OF USE. 1z UNIT HEATERS. VF!%N'T !--(,-4NS.
OCCUPANCY GHP. . :R3 VENTS W/O APPL: VENT SYSTEMS:
J R I E BOIL ERS/GOMPRE9SGRS HOODS...
DUEL TYPES-------------- 0-3 HP. . . . : 1 DOMES. INCIN-.
-/ELE/ 3- 15 HP. . . . COMML. INCTN%
MAX INPLO BTU 15---30 HP. . . . REPAIR UNITS:
FI RE 30 -,so HP. . . WOODSTOVES. .
3PS PRESSURE— ,- 50+ HP. . . . CLO DRYERS. .
NO,, OF UNITS_._ - -- -- AIR HVINDUING LJN I TS OTHER UNITS.
FURN " 100K BTU.- CY 10000 cfm: OAS OUTLETS. :
E=URN ) -11012)K SI-U; 100010 cfm
-.
Remar-kc .- AIR COND17- IONING
Owney', FEES
DON WALLAUE t ypp i'mol.111t by ciat ,�, r'P('.'pt
9185 SW 69TH V,'RM-( $ 16. 00 JLH Q16/12/91
a P C T $ 0. 60 JLH 06/12/91
rmppv oR
;uNsET F1JFL
-.944 SE POW11-i-L
"'0 BOX 142187
C-,ORry'LAND OR
--ri o ri e #s a 34--0611 16- 60 (01PL
REOUIR17D INSPECTIONS
rii pereit it issued subject tc the recvlations curtained in the Fir?,nl ln:ipection
Tigard gunicical Code, State of Dyv. Specialty Cadet and all other
3ophratIp laws. All work will he done in acco"dwe with
,ocroved 'gips. This pprvt Will excire if work is not started
ithin Iff days J issuance, or if work is suspended for oar#
'han ',8@ Gaya,
L�41. 1 fm'. IrIsppc�tiori b. 9-4.1 /n
Vt- I IUAK1i.1' MECHANICAL PERMIT Pe
Parmit N
' - Oeecrlplfon
._ TWO]A Mochiaro"Code CITY URIC! AAT
City of Tigard
13125 S.W. Hall Blvd. 1) Permit Fee _ — -0- -o- 10.00
�
P.O. Box 23397
Tigard, OR 97223 U 2) Supplemental Permit 3.00
639-4175 Furnace to 100,000 BTU
�j 7e#- cIc Wir-cleria 1) incl.ducts&vents 6.00
Furnace 100,000 BTU +
2 incl.ducts&vents 7.50
i
Na of Devxi, ! 3) Floor Furnace
( , incl.vent 6.00 -
Job Addres. Suspended heater,wall heater
Address - ��:.� -.__. - 4) or floor mounted heater 6.00
Tax I or Map NoVent not incl.in
Lot SOMA subd vision 5) appliance permit 3.00
Name(or name of buwwss) Repair of heating,ref ig.,
A /1.1 ���C/' 6) cooling,absorption unit 6.00
"Address fTl_ PhoneC 7) Boiler or comp to 3 HP
Owner r l absorp.unil fo 100,000 BTU 6.00 (t!
J
C tyrSlata rip ) Boiler or Comp to 3 HP-15 HP
5 absorp,unit to 500,000 BTU 1 1.00 --
N Boiler or camp 15-30 HP
t I Z ' 9) absorp.unit 1/2 1 million 1500
Boiler or compto 30-50 HP
' r 'e� Y(J L �I`r {� 10) absorp.unit 11.75 millin 22.50
Contractor G s�t`e'1 Zip `1 11 Boiler or comp to 50 HP - 3150
(
-1(,-
3/( 0Z zip. 11)) absorp.unit 1,750,000 BTU _-
State p stralim No. (5 vCri tip.Tax No Air handling unit to
e� (1j(A 1 Cl C-f / N 12) 4.50
10,000 CFM
Air handling unit
I hereby acknowledge that t have read this aroicatlnn that the information given is 13) 7.50
10,000 CFM a
C(Xlect,that 1 am the owner L,aufflonzed agent of the owner,that plans submMod are in
compliance with Stale Laws,that I am registered with the State Builders'BCMId,that the Non portable
number given is pprrect.(It exempt hive om Stale registration please greason below). 14) evaporate cooler 4.50
_
15) Vent fan connected
-- to a single duct 3.00
---- Ventilation system not
16) included in appliance permit 4.50
-------------------
Hood served by
17 mechanical exhaust 4.50
Signature(owner or agent) Date ) Domestic type
Describe work 19 incinerator 5d
O addition p atteralion repair ❑
to be done residential non-residential (] ) Commercial or industrial 30.00
Existing use of 19 type incinerator
building or properly 20) Other i.e.,woodstove,water 4.50
Proposed use of heater,solar,clothes dryers,etc.
building or properly ) p'v' 9
cr 21 Gas piping one to four outlets 2.00
N Type of fuel- oil CI natural gas 0 LPG C1 electric
? 22) More than 4•per outlet -- -
.~, NOTICE SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
cc
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 190 So-IO 406 SURCHARGE
C.0 - ---- - ---- —
4t DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR L
ABANDONED FOR A PEF4100 OF 190 DAYS AT ANY TIME AFTER
WORK IS COMMENCED TOTAL
Special Conditions _.--.- �_-- •--.___