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5
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.�, Date:
a R O J E C T {N F 0 4 M A T i J N — 5.., A.- tisv ATH Trr: U$hf�• w
YIED EI_NG. I
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',P IFASTEIIU,G Pte. TS
BUILDING OWNER: PACIFIC REALTY ASSOCIATES, 1 .P. �=W----S,,SKIICEDMuNG
15115 S.W. SEQUOIA PKWY *200 I
I I PORTLAND, OR 97224
f
TENANT: Ili BATT tiI',IN
I � BLUEBIRD TRA�JSFER, INC.fNC
OCCUPANCY: 8-2 CY_
" t :,4 i- CONSTRUCTION: V-N 35;9 STLCS02a-ae ?Li
/b'GYP W.BCTH SLOES
FLOOR AREA: 1,280 SF OFFICE OFStUJ
12,537 SF TOTAL
of t
tI
\ r /� I n I
�E �JLR NATES
!!' z 2 1 i ALL CONSTRUCTION WCQK SHALL BE DONE IN STRICT
ExrS-I<iG CEMISING t,AL:. + COMPLIANCE WITH THE LATES' EDITION OF HE UNIFORM
BU'LOING COQ. AS At,Ac`4rJEG 8v T-!E CTAT:.OF OREGON AND --- s 1/2-BAT-INSULINATTENUATgFIWALLs
i I I ALL OT;-ER ;TATE OR _PCA, CODE REOU RE!21ENT5 THAT —o'ptlBgERBASr-rYP
I I I AP aL Y
j —� CARPET AK,PAD
2. 1-= CONTRACTOR STALL VERIFY ALL CIMSNS'ONS AND F"SMFLCOR-TOP CFS�ABy-
CNDIT!(4NS SHOWN ON DPA'WINGS AND AT THE EXISTING QV
BUILDING AND NOTIFY ARCHITECT OF ANY DISCREPANCIES w C'4
• _J e. ,- I ! t PRIOR TO STARTING THE WORK. >
TYPI � A ' WALL SE '_' T ! CN m NQ" n
r :rc c•:x j I ? CONTRACTOR S"ALL KEEP THE AREA 0: '1 ')PK FREE !✓F 1, w
G 3 S, CLUDING POCK W z
•- -�- -:r r - - _...,,� -, *--n., ! 3ARBA.GE AND DEgP;S ON A DA-LY AS, 'N �C ALE I 1•-0 � Z o
ACCESS AREAS.
E r I m 3
= "` .`:•C , �• I { 4. CONTRACTOR SEAL_ KEEP TME ROOF =REE OF DEBRIS GLLJ Z
.E. U Z N�
c 1: C• I '
NAILS. SCREWS) AT ALL TIMES J
,, �, ,I 1_ r•�� , 1 I I I �J U Ln
C -T • _ - ��-::"-.;�... ._.. .(, I 5. ALL PSUM COARC TO
_ --_ BE A MINIMUM F 5/8H: K
gS W 7�
CO
Ce In 11- TYPE S-12 awiTo A EWS t2C„ fz- J _VEP-ICALLY AT'ACHED TO 35/8` METAL STUDS 24' OCU
a
! ORS I 5. WATER RESISTANT GYPSUM BOARD SMALL 3E INSTALLED
�- rr :c^ .r.zr.-:er' - __ -rzr. - _` 'tl+. I _ - -----__ -------_ --- --- VE THE NI E L� 9cH' ALL =--- G 0 R rIAIr II
-
1_7 _ _. 48" A9G Ff SHE'D FLOOR �N THE We O EXISTING T KmAm
I
-- z r �y ~----- -- i--1--------' DLUM;BING c)XTURES IN TOILET ROOMS
NEW CONSTRUCT'GN
? TO!LE- 1400v FA,SE SMALL EXTEND 5" ABOVE THE FINISH NEW PAPTIAL HEIGHT WA L
4 ',n =C w: r,`sE. FLOOk 0"1 ALL WA_LS
�' , � � � ��` I I ' ��• !SFW DEMISING WALL
B. N FINIS-IED SPACES FURR DUT EXTER►iR , r►1CRETE WALLS
WITH 5/8" ^^YPSJM BOARD OVER METAL STUDS W/R-11 ' HOUR PAR'ITION
REVISI�)NS
-AS NSULATION OR 1 1/2" FUQPAG �HANNALS AT mains PARTITION W/S'JUNG AT'ENUATION BATT ;
Y 24"O.C. W, =JAM SOAP.;' !NSULATION.
fil % C ! CE NTE0t:E'VNAii
_ —
9 CONTRACTGR TO PROP-PLY PATCH ALL 0C,OF PENETRAT ONS
$ 51..TCH
----\ ; \ I ~� FOR 'WATERTIGHT SEAL �q W T H WITH REOSTAT
F'- - ----
I +�*�=ti� ' r [Nil I --I — \ I 1 A J ALL DOORS SHALL 6E 3'-C'. 1'-0' it 1 3,'4* SOLID CORE THREE WAY S1o1TCH
g .--. WOOD UNLESS NOTED 0 HERWISE. DOCK HA DWARE SHALL [` SIGNAL OUTLET
!, N
CE!tV'
_ _ z�+ :..:� ".. ,«.• TY_ � - `�� !
BE SC-ILAGE OPBI' SUES BUTTS COLOSERS AND OTHER
RCWARE TO BE 61? FINIS
0 T ISOLATED AROUND
I � JE ICATED OU�LE IS T
ti
__- _ _ --- _--• I �' ,_^ A �� - / A — I r 1. COI SyICAL CEh. NS SYSTEMS' ' DUP_EX RECEPTACLE !
I I SUSPENSION SYSTEM TO BE EXPOSED METAL T-BAR, c.
j �-� + ..�-• -I �---- — �.. I I PRErl%iSHED WH;T T OS. O.'RPLEX RECEPTACLE II
! i ! I , --� - �—I ---•�--!-._-,-._r....♦__.L—�.- --� E, 0 COMPLY WITH U.S.C?. STANDAR,,..;.
INSTALL LATERAL BRACING PER CODE. SPECIAL OUTLET
PARTITION AND P G W r R PLAN
I � + r [. H.v.AC TO BE A BALANCED. DESIGN BUILC S rsTEti'. � TELEPHONE OUTLET
_�. ._--., �- -1 - -
---i I 13. PROVIDE DP.AFT41PE STOPS AS REQUIRED BY CODE. >� FLOUR MONUMENT WITH SERV'CFS SNGW
! 2 , 4 FLUOPESCENT FIXTLPE ATE: 9/ 12/91
E- I .4, PROVIDE ;PP:NKLEPS BELOW SUSPENDED CEIUNG PER CODE.
I _ I I � �— I � 2 >, 4 STEADY BURN FLUOR_ ;!XT.
15. DUCT AL'_ EXHAUST FANS. MOUNT ABOVE SUSPENDEC CEILING A C , a FLUOR, FIXT. W/ ACRYLIC T.
I I I TO MINIMIZE MOTOP NOISE. LENSE
+ IIr;,ANDESCENT DOWN LIGHT
`'•,, --sTAn G*V AT gnu"' _ - - --- - -^-- -~- 16. PROVIDE LABEL FOR EACH CIP!'I,) T AT PANEL FOR
WA"cc GrrCF IDENTIFICATION PURPOSES. THERMOSTAT LOCATIONS TO BE - SMOKE DETECTOP
GM0 WA1% REVIEWED BY' OWNER PRIOR TO INSTALLATION.
• SPA+NKLEF± HEAD
t(I �� + `I A�1'Vl't 11. TELECOMMUNICA-ICN SYSTEM By TENANT. C04TRACTOR TO BUILDING STANDARD SUPPLY VENT
1- F) ! ' � COORDINATE W:1RK.
''' � "' � � FLECT �. D CEILING r � N, �,
BUILDING STANDARD RETURN VENT
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INSPECTION NOTICE
City of. Tigard Building Department
13125 :.N Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Dueinene Phone: 639-4171
Inspection•- _,_.
Footing Plbg. Undorelab Mech. Rough-in Appr/Sdwl.k
Pound. Plbq. Top Out Gas' Line FINAL:
Post/Beam Struct. San. Sewer Frmkming -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Line Gyp. Bd. 5-Mach.
Date RequeetedsTi' Q !mes r AM PH
Address: �" TGl �Q ��:-- �^��4Y..1..�_ t&s 1 01,2-5
7
Builder:
TILE FOLLOWING CORRECTIONS ARF REQUIREDs
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Inspector: __ --._---- Datc: _ ---_--�—
ROVEb DISAPPROI'ED - APPROVED SUWRCT TO ADM
Call Por Reinsp.
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
inspection Line (Rec-O-Phone): 639-4175 Rusinoao Phone: 639-4171
Inspection=_ _
Footing
Pl.bg. Underelab Hach. Rough-in Appr/adwlk
Found.
Plbg. Top Out Gas Line FINAL:
d
poet/Beam Struct. San. Sewer Framing -Bldg.
Post/Berm Hoch. Rain Drain
Insulation c - 1P umb_
pltg. Underfloor Water L�in�e- Gyp. Bu.
-Hoch.
Time: �_1W PH
Date Requested t, /71 /
permit
Addrese:
Builder:
THE FOLLOWING CORRECTIONS ARE REQDIREDi
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Inspector: � "
✓ApPRpyED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call Fcr Reinsp.
MECHANICAL
CITYOF T_VARD PERMIT'
COMMUNITY DEVELOPMENT DEPARTMENT �CrFYOFTWARD PERMIT #. . . . . . . : MEC91-0175
13126 SW Hill Blot P.O.Bcw 23397,Tigard,Oregon 97M(6W)6*�l 75
' J- I j. r1. '�� DATE ISSUED: 10/05/91
SITE ADDRESS. . . : 15865 SW 72ND !4VE PARCEL: 25I12DC-0021211
SUBDIVISION. „ . . . SP TIGARD INDUSTRIAL PARK ZONING: I—P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :3
CLASS OF WORK,. ALT FLOOR FURN. . . . EVAP COOLERS:
.ryp,E OF USE. . . . C011 UNIT HEATERS. . : VENT FANS. . . :2
OCCUPANCY GRP. . :B2 VENTS W/O AFFIL: VENT SYSTEMS:
STORIES. . . . . . . . : 1. BOILER5iCOMPRESSORS HOODS. . . . . . .
FULL 0-3 HP. . . . : 1 DOMES. INCIN:
. /GAS/ 3-15 HP. . . . : COMMi.— IN(-'IN:
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
P'I RE DAMPERS?. . :N 30-50 HP. . . . - WOODSTOVES. . :
GAS PRESSURE. —!L 50-+- HP. . . . : CLO DRYERS. . :
NO. OF UNITS-------------- AIR HANDLTNG UN ITS OTHER UNITS). :
FURN ( 10OK' BTU: 10000 cfryl : GAS OUTLETS. :4
1---URN ) =100K BTU: > 10000 cfm :
Remarks; Tenant Impr. add int walls, tlt rms, breFk rm.
Owner: FEES
PACIFIC REALTY ASSOCIATES, LP type amoL!nt by date recpt
15115- 13W SEQUOIA PARKWAY PRMT t 25. 00 JLH 10/0B/91
PLCK $ 6. 25 JLH 10/08/91
1'IGARD OR 9*7224 5PCT $ 1. 25 iLl-A 10108191
Phc-ie #: 624-6300
Contractor:
PROTEMP ASSOCIATES INC.
807 N. E. COUCH
1'URiLAND OR 97232
1--'hone #: 2,33-6911 32- 50 TOTAL
Reg 38868
REDUIRED INSPECTIONS -------
Inis permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Heating Unt Insp
approved plans. This permit will expi-e if work is not started Cool inq Unt Insp
within 180 days of issuance, or if work is suspended for more Dl-ict Inspection
than lo@ days. Final Inspection
Ln Permittee Signati-irp :
V
il Call for inspection 639-4175
J
11
CITYOF TIGARD
C17YOFIWARD
COMMUNITY DEVELOPMENT DEPARTMENT cNoo+s PLUMBING PERMIT
13125 SW FW!Blvd. P.O.Bar 233Q7,Tl�ard,Oregon 91223(603)834 175
PERMIT #. . . . . . . : I 'I_M91--01.65
639--4171 DATE ISSUED: 10/02/91
SITE ADDRESS. . . : 15865 SW 72ND AVE PARCEL: _'S112DC--00201.
SUE{DIVISION. . . . ; SF' TIGARD INDUSTRIA(_. PARK ZONING: I—P
81_OGI:. . . . . . . . . . LOT. . . . . . . . . . . .
CLASS OF WORK. . .-ALT bARBAGE DISPOSALS. . 1108I1 E HOME 51='ACES. :_
TYPE: OF USE. . . . :COM WASHING MACH. . . . , . . ; BACKFLOW PREVNTRS. .
OCCUPANCY GRP. . :B2 FLOOR DRAINS. . . . . . . : 1 TRAPS. . . .
5"l'OF?I ES. . . . . . . . : 1 WA1'`=R HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . .
FIkTURES-- --_._.________— LAUNDRY TRPYS. . . „ . . : �-73F RAIN DRAINS. . . . .
SINKS. . . . . . . . . . : 1 URINALS. . . . . . . . . . . . . GREASE TRAPS. . . . . . . .
LAVATORIES. . . . . :2 OTHER FFIXTURES. . . . . :
TUB/SHOWERS. . . . : SEWER LINE (ft ) . . , . :
WATER CLOGETS. . :e WATER LINE
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . . :
Remarks : Tenant ImDr. add int walls, tlt r'ms, break rm.
Owner-: --- --- ------------------------- -------------- FEES
PACIFIC REALTY ASSOCIATES, LP type amor_rnt by date recpt
15115 SW SEQUOIA PARKWAY PRMT $ 52. 50 PCR 1Q./02/9.1 —
PLCK $ 13. 13 BCR 10/02/91 —
TIGARD OR 97224 3PCT $ 2. 63 BCR -
0hone #: E24-6300
Contractor: --------------_._._._--__--_--__
JOHN RFINHARDT PLUMPING
P 0 LOX 129
NEWS.;ERG OR 97132 ----_--___-.__--_--____________________..._
Phone #: 620-3754 $ 68. 26 TOTAL
Reg #. . : 01870
---- REQUIRED REQUIRED INSPECTIONS -------
This permit is issued subject to the regulations contained in the Rough—in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Top—out Insp
applicable laws. All work will he done in accordance with Final Inspectian
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 188 days.
N I erm i t t e e S i gnat i_tr-e
i s s i_i ed By :
Call for, inspection - 639-4175
CITYOF TIGARDBUILDINGRD PERMIT
COMMON" DEVELOPMENT DEPARTMENT OR190% F,ERMIT #. . . . . . . : BUP9 I
13125 SW Hall Blvd. P.O.Box 23397,Tip W,Oregon 97223(503)ON 4175
li'64_ .' i;x; E4)TE ise;HEDa 08111-301191
SITE ADDRESS. . . : 15865 SW 721\11) AVE PARCEL' 2Sll2DC-01Z1c-_:1Z1J
SUBDIVISION. . . . : SP TIGARD INDUSTRIAL PARK ZONING: I-P
BLOCK,. . . . . . . . . . . LOT. . . . . . . . . . . . . :3
----------------------
REISSUE- FLOOR AFREAS- EXTERIOR WALL CONSTRUCTION
CLASS OF WORK. :ALT FIRST. . . . : 12184 sf N- S: E: W:
TYPE OF USE. . . -COM SECOND. . . - sf PROTECT OPFNINIGS?------------
TYPIE OF CONST. :3N THIRD. . . . . sf N: S: E: W:
OCCUPANCY GRP. :B2 TOTAL------: 1 1134 s-F ROOF CONST:B FIRE RET? tY
OCCUPANCY LOAD:34 BASEME..*NT. : sf AREA SEP. RATED:
STOR. . 1 1-1 T. .24 ft GARAGE. . . : sf OCCU SEP. RATED:
B SMT? :N MEZZ?:N RECD SETBACKS----- REQUIRED-------- -
FLOOR LOAD. . . : 125 psf L F�'.*F T- ft RGHT: ft F I R SPKL:Y SMOK DET. . :1\4
DWELLING UNITS: FRNT: ft REAR: ft FIR AL.RM:N HNDICP' ACC:Y
BEDRMS: BA-H-45: IMP SURFACE: PRO CORR:N PAR1-1,ING:
VALLIE. $ : 25000
Remarks : Tenant Impr. acid int walls, t l t rrs, break rm.
Owner: ------ FEES ----------------
PACIFIC REALTY ASSOCIATES, LP type amol.tnt by date reept
15115 SW SEQUOIA PARKWAY PRMT 4i 1.-0. 5V JLIA 09/ 19/91 617647
PL.CK $ 110. 811 JHL 09/19/91 217647
TIGARD OR 9-72-24 FIRE $ 68. 20 JHL 09/19/91 217647
P'lione #: '_,24-6300 ,5P('T $ 8. 53 JLH 09/19/91 217647
Contractor-:
--_.____..._.__._____._____.---_.___._--
H. L. GREEN COMPANY, INC.
1-5115 SW SEQUOIA PARKWAY, SUITE '00
llb-ARD OR 97224--71.31 -----------------------------------------
Phone #: 624- 7717 $ 358. 06 TOTAL
Req #. . : 41328
REQUIRED INSPECTIONS --------
This permit is issued subject to the regulations contained in the Slab Insp
Tigard Municipal Code, Stice ;f Ore. Specialty Codes and all o.hpr Framing Insp
applicable laws. All work will be done in accordance with Ins i-Ilcit ior) Insp
approved plans. This permit will expire if work is not started Gyp Board Insp
within 180 days of issuance, or if work is suspended for more Si.isp Ceilng Insp
than 180 days. Final Inspection
C�
Permittee Signatk.tre:
Sy -
cc +—/Call for, inspection 639--4175
1.
C.D
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SEWER CONNECTION
CITY OFTIFARD PERMIT #PERMIT. : SWR91-0185
CMO;TWARD . . . . . .
COMMUNITY DEVELOPMENT DEPARTMENT OREGON
13126 SW HWI E lvd. P.O.Box 2M97,Tlgiud,OrWm 972M ISO)43W4175 DATE ISSUED: 09/30/91
SITE ADDRESS. . . : 15865 SW 72ND AVE PARCEL: 2SI12DC--00201
SUBDIVISION. . . . : 5P TIGARD INDUSTRIAL PARK ZONING: I—P
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :3
TENANT NAME. . . . . :BLUEBIRD "TRANSFER
USA NO. . . . . . . . . . : FIXTURE UNITS. . . : 18
CLASS OF WORK. . . :ALT DWELLING UNITS. . : 1
TYPE OF USE. . . . . :COM NO. OF BUILDINGS: 1
INSTALL. TYPE. . . . :BUSWR IMPERV SURFACE..:
Remarks : Tenant Impt-. k(J(-j int wal.1s, t1t r-ms, break r-m.
Owner: FEES
PACIFIC REALTY ASSOCIATES, LP type --RM01.tnt by date rec-pt
15115 SW SEQUOIA PARKWAY PRMT $ 1900. 00 JLH 09/30/91 02
TIGARD OR 97224
Phone #: 624-6300
Cont r-ac-tor,:
H. L. GREEN COMPANY, INC.
151. 15 SW SEQUOIA PAPKWAY, SUITE 200
11GARD OR 97224-7131 ------------------------------ ----------
phone #: 624--7717 t 1900. 00 To rAL
Reg #. . .- 413C28
REQUIRED INSPECTIONS
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 120 days from .......
the date issued. The total amount pais will be forfeited if the
permit expires. The Agency does not guarantee the accuracy of the
side sewer laterz!s. If the sewer is not located at the measurement
given. 0? installer shall prospect 3 feet in all directions from
the distance given. if not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
iDet-ry,ittee- 5iqT)�:4t1tree -.
Issl.ted By :
Call for inspection 639--4175
PL.NCK RECT # � – X17& 2
CITY OF TIGARD 13175o(lot 3397ll � —
ro[Mx Z7J97 PERMIT #
COMMUNITY DFVELOPMENT DETAirrmENT 1igard,oregon97M
(503)639-4171 DATE ISSUED
JOB ADDRESS: '� y� TAX MAP/LOT
SUB: ___ LOT: I-AND USE: _
VALUATION: -
OWNER SPECIAL NOTES
NAME: Pacific Realty Associates, L.P. (PacTrustl . REISSUE OF:
ADDRESS: 15115 S.W. Sequoia Parkway. Suite 200 LAST REISSUE:
_ Portland, OR 97224 FLOOD PLAIN/
PHONE: 624-6300 _ SENSITIVE LAND:
CONTRACTOR APPROVALS_RE UIRED
NAME: - H.L. Green Company PLANNING: Cil- --
ADDRESS: 15115 S.W. Sequcia Parkway, Suite 200 ENGINEERING: --
_ Portland, OR 97224 FIRE DEPT:
PHONE:— 624-7717 OTHER: -
CONTR. COARD N: 41323 — EXP DATE:
ITEMS RE0UIRCD
SUBCONTRACTORS: PLUMB: �� LIST/SUBCONTRACIORS: --- - -
MECH: _ BITS TAX: -_-- --- -
ARCE1/LNG I NEERCAIJ ULAT IONS:
NAME: John H Romish __ - TRJSS DETAILS: -
ADDRESS: 2216 S.E. 24th Avenue OTHER: _ --
Portland OR 97214 _
PHONE: 236-6;06
a
H PROPOSED BLDG. USE: -
COMMENTS: > -
V
W
J
APPY CAN SIGNATU ' -
Received By: Dale Received: P� 7 -�i
i
PERMIT N ACCT N DESCRIPTION AMOUNT AMOUNT PD. BAL. ,DUE
10-432 00 Building Permit Fees _r__, J 76, -6
10 .431 00 Plumbing Permit Fees __ — —
__ 10-431 01 Mechanical Permit Fees
10-2.30 01 State Building Tax (5%)
Building
Plumbing
Mechanical
10-433 00 Plans Check Fee
Building
P1 umb i ng
Mechanical
10-230 06 Fire —
f/-O/8�r
30--202 00 Sewer Connection �CX1.00 .0o
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees
25-148-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees
25-448-03 Office TIF Fees
75-448-01 Residential Traffic Fees
25-448-05 Mass Transit TIF Fees
52-449 00 Parks System Dev Charge (PDC) _
31-450 00 Storm Drainage Syst Dev Chrg
(SSGC)
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of)
101AL
nm/35811'.WP1
CITY OF TIGARD
PLUMBING PERMIT 13125 SW HALL BLVD.
P. O. BOX 23397
Applicants must hold Oregon 'tegistration to caduca a plumbing T IGARD, OR 97223
txnt(sess or must be property owner/operator not hiring outside help.
Name of (5J3)ri��9- l'75 r' j�q1
1_ Plumbing Permit No.
Address -; Description
ORS 814-21-610 DUAN. MICE AMT.
Job Tax Lot Map.No.
Address _ FIXTURES _
int Block Strbdivlslon ok /� 7.50
sr•teT-rwrt'WIR business) Lavatory 7.50_ /C F
Tub or Tut•..,,ower Comb. 7.50
xq. e.. Shower Only 7.50
OwnerCity/;tete i WaterCloskM - /_ 7.50 S
Dishwasher 7.50
Phone~ Garbage Disposal 7.50
N _ Washing Mach ne - -- 7.50
Flax Drain 7.50
y
song Address Pham Waterlieater 7.50
-- laundry Roan Tray 7.50
Occupant City/State zipUrinal 7.50
Name Other F'"aures(Specify) 7.50
7.53
MmLng Address Ptwns 7.50
CoMractor CIty/State Dp 7.50
MISCELLANEOUS
City Bus,Tax No. Sew.:.A 100' 30.00
Stta:! s. I4o. tate s `-Lc.No.
Sew-ea.Addit.100' 15.00
(Hesdentia) Water Service 1 st 100' 20.00
I hereby acknowledge that 1 have rets Chis applir stitxL Cut the iniormatior Water$ervior at Addnl2ODr 15.00
given.s oohed,that 1 am reoriered with the State Buildoes Boats.and also SL-wm b Rain Dre;n t st 100' 30.00
barye a State Pkanbkg Foe:rse Chat fhe nxrli.ers given rna oornsd,that aC
pkxnbing work will be done in wxmm enee with applicaLoo pnovickm ON Ors- Stam b R:r •ain Add t.1C0' 15.00
gon Revised Stalutes Chapters 447 and 1_93 and applicable Miss and that Mottile Nonw apace 15.00
no help will be employed unkm licensed under ORS M3.(11 eKampt from Back Few Prevention `
Shwa registralicn peace give mason eek . Device or Anb Polk9son Device 750
I KWEOWNERS-t hereby ostVy Cat I am the owner of the prop xV de-
aarUed above.N which location 1 propose to make a pkrrtbing k aMaNan for Any T rap or Wash Not
my own use and this propmW Is not being eonstrucled for sale.lease or rent. Corawcled to a Fechxe 7.50
Catch Basin 7.50
--- - kurp.of Exist.Pkmbirg 40.0G Per Rr. --
---- Specially Requested Inspections - 40.00 Per Hr.
Ake.of PkxrbkV within
A an Exacting Bldg. 15.00 min.
AUT"On(ZED SIGNATURE �- Oahe New Bldg.or Build,Addition 25.00 min.
(ascribe:Vtk thew c] addition t IS.QO
be done residential(1 tan roslderllral - --
Fxisting use of
txAk*var:(q)orry-- _-.--- _,-- ; �:_ .(A� minimum SUB-TOTAL S
5% SURCHARGE ,2.25
bulk3t'tp°r►'r°D"'rty- ---- ------- --- 2 5 N PLAN REVIEW
NOT"
The pamrlt b000mas ry dl and Wold*wrxk or oonatnxa{on au0mxU ad to not onm- TOTAL
"wnoad w4C*r 190 de"Ar It onnslnrdkxr or wcxk is slapardad or abandoned for
a p~of 180 dogs of any area aflor w irk Is oortwn enced.
Oste Issued �- -- _ by ------�--- ---
CITY OF TIGARD MECHANICAL PERMIT tiecelpt
13125 SW HALL. BLVD. Permit#,��(�/75
P- 0. BOX 23397 Description
T IGARD, OR 97223 Table 3A Mechanical Code CITY PRICE AMT
(503)639-4175 i 1) Permit Fee -0- -0- 10.00
Name of Development
2) Supplemental Permit 3.00
Job Address - 1) Furnace to 100,000 BTU G.00
Address ?,_ S �� L~ j incl.ducts&vents
Tax Lal Map Na. Furnace 100,000 BTU f
tnt 2) incl.ducts&vents 7,50
Block subdivision
N f name of business) Floor Furnas e
��r�T.� 3) incl.vent 6.00
Mailing Address Phone -` Suspended heater,wall heater
Owner 4) or floor mountedheater 6.00
Ciryist;ate Zip Vent not inc,.in
5)
appliance psrmit 3.00
Name(or name of business) Repair of heating,ref r ig.,
6) cooling,ab!>orption unit 6.00
Mailing AddressPoona Boiler or camp to 3 HP
Occupant I 7) absorp.un t to 100,000 BTU 5.00
Cityfstale ZipBoiler or camp to 3 HP-15 HP
8) absorp.unit to 500,000 BTU 11'00
Namu 9) Boiler or comp 15-30 HP
absorp.unit 1/2-1 million 15.00
Nailing Address Phone 10) Boiler or comp to 30-50 HP 22.50
absorp.unit 1 -1.75 million
i
Contractor City/Slate Boiler or comp to 50 HP
Zip 11) absorp.unit 1,750,000 BTU 31.50
State Registration No. City Bus.Tax No. 12) Air handling unit to 4.50
10,000 CFM
i
I hereby acknowledge that I have read this application that the information given i13s ) Air handling unit 7.50 10,000 CFM +
cared,that I am Nle owner or authorized agent of the owner,that plans submitted are in --
compliance with State IaW3,that I am registered with the State Builders'Board,that the 14 Non portable
number given Is correct.(if exempt from Stat.)registration please give reason below). ) evaporate cooler 4.50
Vent fan connected �) I
-- --- 15) 3.00
to a single dura _
- —
,�---_ 16 Ventilation system not 4.50
--��.--_�— ) included in appliance permit
Hood served by
17 mechanical exhaust 4.50
signature(owner or agenq _ Date ) Domestic type 7.50
Describe work El addition n alteration 41 epair ❑ 18 incinerator
to be done residential ❑ non-residential19) Commercial or industrial 30.00
Existing use of - type incinerator _
building or properly— 20) Other i.e.,woodstove,water 4.50
Proposed use of --
heater,solar,clothes dryers,etc.
building or property 21) ras piping one to four outlets 2.00
N
Type of fuel- oil P natural gas ] LPCI I I electric I I —
►- 22) More than 4-per outlet
-j NOTICE -- --"—
--- SUB-TOTAL
C4 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- -
LL STRUCTIO14 AUTHORIZED IS NOT COMMENCED WITHIN 180 5%ISURCHARGE
-' DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY 1 IME AFTER — — ---
WORK IS COMMENCED. TOTAL
Special Conditions
_ hate Issuers by I