9625 SW 69TH AVENUE ADDRESS:
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�� �,, ITY OF TIGARD BUILDING INSPECTION DIVISION
A1.A&ur Inspection Line: 639-4175 Business Line: 639-4171 MST
' BUP
A - Date Requested �� AM_ PM BLD
Location �c11 S� (G 61 ' Suite �ME 0/ -1--6����2_Z—
Contact Person 6zw'z PLM
Contractor Ph ��/�- _ Lt'U SWR —�
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation FPS
Ftg Drain SGN
Crawl Drain Expired/Research/Request
Slab SIT _
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkles
Fire Alarm
Susp'd Ceiling -
Roof
Fina
PASS PART FAIL ------------- -- -- --- -
PLUMBING
Post& Beam — - ------- — ----- ---�.._._._
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Dratins -
Final -
PASS PART FAILWtM
NIC h
Rough In
+ —� -
Gas Line — --- ---- ----
Smoke Dampers -
�ASPART FAIL
CTRICAL -
Service, -
Rough In
UG/Slab -a -
Low Voltage
v Fire Alarm _ - --
>- Final
~ PASS PART FAIL -__ — ---
SITE
Backfill/Grading
uC-9, Sanitary Sewer
J (Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin j j Please call for reinspection RE: _ —_ ( J Unable to inspect-no access
Fire Supply Line ----
ADA
Approach/Sidewalk Date _ Inspector �`-��' EXt�r
Other —
Final
PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site.
CITY OF T I G A R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC1999-00472
' DATE ISSUED: 11/04/1999
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 PARCEL: S 12IS125DA-
A-06500
SITE ADDRESS: 09625 SW 69TH AVE
SUBDIVISION: KINGS VIEW ZONING: R-4.5
BLOCK.: LOT: 052 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INC-iN:
MAX INPUT: BTU 15 -30 HP:
FIRE DAMPERS?: 30-50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: CLO DRYERS:
S:
FURN < 100K BTU: 1 AIR HANDLING UNITS C
OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:
> GAS OUTLETS:
10000 cfm:
Remarks: Replace existing gas furnace in single family dwelling.
Owner: _ FEES _
HOAGLAND, DEAN GUY AND ZOLA Type By Date Amount Receipt
9625 SW 69TH PRMT KJP 11/04/191 $50.00 99-319558
TIGARD, OR 97223 5PCT KJP 11/04/19 $4.00 99-319558
Phone: Total $54.00
Contractor:
A-TEMP HEATING + COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Heating Unt Insp
Phone:650-5014 Final Inspection
Reg #:LIC 00071878
ELE 3-374CRE
og4G�J` AL
LZ
Y
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 work will be done in accordance with approved
plans 1-his 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 ii, the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain cop' s f these rules or direct questions to OUNC by calling (503)246-9180.
Issue By: Permittee Signature: �.�
Cali (503) 639-4175 by 7:00 P.M. for inspections m3eded the next business day
C I0j u u z
RECEIVI7 t 1 Plan Check z
Recd By_ _
• OCT 1 a;(iemai -and Resideniial Datc ReC'd
Vhl 97223 Date to P.E. _
(503) 639-4171, x304 COMMUNITY UkvklUrlvi' -� oatetoDST
R.., U( Type l`1 Perm4* t°< rt 9 "� y?)
Incomplete or illegible applications_will not be accepted Called
Name of Qevelopmentipro)cct De-3Cfipt16n
U� Table 1A Mechanical Code Qt Price Amt
Joh 3lreet Adtk Suitelr A Permit Fee _ 7.1 7 I ;,;. 16.00
Addres9C1 r j�J ��� P 1) rurnaceto100,000UTU p
including ducts&vents ae.r f000tetn1,2 9.65 /,�a5
aldga cnrfstetezip 2) Furnace 100,000 BTU+
Ti Cir including ducts d vents soo footnote 1,2 12.00
Name(or name of business) 3) FIOnr Furnace --- - +
Owner /1 1A t) includinvent see footnote 1,2_ 9 6S
M III ,ddress 4) Suspended heater,wall heater
or floor mounted heater see footnote 1,1 Q6 _
(J , At Ave. 5 Vent not included in a (lance Reit 4 7,1%
City/state tipPhase Check all that apply. 'Boiler Heat Air
y / r-, ? CI For ftems 6-10,see or Pump Cond Oty Price Amt
Na (or nam of buc! Ise)
ootrtotsrs 11,2
6)<3111P,absorb unit to
.
Occupant Mautngnddres100K BTU 565
: 7)3-15 HP;absorb unit _ -
I 00k to book d I U 17 65
cnyt uAe zip phone -- 8) 15-30 HP,absorb
unit.5.1 toil BTU 24 15
Controetor Name - 9)30.50 HP;absorb
/n
unit 1-1.7 5 mll BTU 3600
6- Til117P 10)>50HP,absorb unit
Prior to penrn Melling Address _ -1.75 mil BTU _ 60.15
Issuance,a copy 16,06Q e I I f Air handling unit to 10,000 CFM
of all licenses C ly State Iphone _ _ 1.00
are required 0 a_r�- f r' o/
% S C O 12)Air handting unlit 10,000 CFM+
expired in COT oregan const cant card Lie.N Ex p Date 11.75
database LA 73)Non-portable evaporate cooler
Architect Name 7.00
14)Vent fan connected to a single duct
Or Mooing Address 4.76
15)Ventilation system not included iR
_a_ (lance ermit 7.00
Engineer Citylstate 71p Phone FP.___ ._� _ _ --__
!� 16)Hood served by mechanical exhaust
_ 7.00
Deacrlbe work to be done: 17)Domestic Incinerators
12.00
New O Repair O Replace with like kind: Yeg3 No O t Hl Commercial or Industrial type Incinerator
Residentlal` Commercial O 19)Repair units 25
Additional Infntmation or dencrlption of v�otk 13_40
'A
�� _I`tom Ck (-A- 20)Woonf!s
Wood stovelgas Mother u �'cloPm drye0esc.
'C' 7.1J0
NOTE: For Commercial projects only;Units over 400 lbs.require 21)ran piping elle to four ntttlels
structural gas calve. See footnote 1 3.75
Type of(list oil o nature(gas O LPG O electric O22 Mone than 4-per outlet each) .75
_ Minimum Permit Fee 560.0.0_ ---SUB IOTAL !
1 hereby acknowledge that I have read this app!P;atlon,that the Inb,nnation 114 SURCHARGE
qt/en is correct,that I am the owner or attlhorized agent of PLAN REVIEW 251A OF SUSTOTAI. ju
the owner that plans submitted ere in compliance with Oregon State laws. Required for ALL common tial permits,ont i,I
' TOTAL
!logo re of Owner/Agent Date
Other Inspections and For,e:
1. Inapectlone outside of noi,nal bustnpss hours(mininum charge-two
Contact Person Name Phone hours) $50 00 per hour
7 Itispectlont for which no fee Is specifically fndicatgrt (minimum
/ chargo-hal' hour) $50.00 pet hour
10vFoonofas farcamrtertiaf profecb only, 3. Additional),Ian review regtdred by changes,additions or revialrins to
. Provide full schematic of existing and proposed gas line and pre imire pians(mieirnum charge one-half hour)$C.0.00 per hour
2 Provkle drawings to scale showing existing and proposed mechanical
units. Stall Contractor Sailer Certification required
"Residential NC requires alto plan showing placement of unit
I tmechperm der rev 7/19/99