InitiallyGood 14965 SW 96'" AVE.
/ CITY OF TIGAR D _ PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT#: PLM2000-00083
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 03/14/2000
PARCEL: 25111 B D-00411
SITE ADDRESS: 14965 SW 96TH AVE
SUBDIVISION: DARMEL NO. 3 ZONING: R-3.5
BLOCK: LOT: 031 JURISDICTION: TIG
CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: FLOOR DRAINS: TRAPS:
STORIE=S: WATER HEATERS: I CATCH BASINS:
FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS:
`— SINKS: URINALS: GREASE TRAPS:
LAVATORIES: OTHER FIXTURES:
TUB/SHOWERS: SEWER LINE: ft
WATER CLOSETS: WATER LINE: ft
DISHWASHERS: RAIN DRAIN: ft
Remarks: Conversion of electric water heater to gas.
FEES
Owner:
Type By Date Amount Receipt
KIMBERLY ZENZANO PRMT KJP 03/14/200C $50.00 0000648
14965 SW 96TH 5PCT KJP 03/14/200C $4.00 0000648
TIGARD, OR 97224
Total $54.00
Phone 1:
Contractor: _
ENERGY MASTERS INC
7470 SW 76TH
(SUB'S CCB EXPIRES IN 1/2001) REQUIRED INSPECTIONS
PORTLAND, OR 97223 --- --- ---- —
Phone 'I: PH 244-8880 Top-out Insp
Reg #: LIC 00058556 Final Inspection
PLM 26-476PB
rRIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable laws. All work will be done in accordance with 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. Oregon law ,-equires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987. 1
Issued By: / I `� t ''��L ti�' Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for an Inspection needed then business day
CITY OF TIGARD Plumbing Permit Applications Plan Check
13125 SW HALL BLVD. Commercial and Residential Recd By
TIGARD, OR 97223 Date Recd
(503) 639-4171 Date to P.E.
Print or Type Date to DST
Incomplete or illegible applications will not be accepted Permit# ►�c rLf LOac, -cvo�3
Palated SWR#
Called
Name of Development/Project FIXTURES (individual) QTY PRICE AMT
Job Sink 11 50
Address StreetAddress 4� Suite Lavatory 11.50
I Jv- i ub or Tub/Shower Comb
11.50
Bldg# Qty/State l Zlp - Shower Only
L ZC [�� "( '7 2?q Y 11.50
Name Water Closet 11,50
V
F I VI L kl f V e 6 L Ll ti l �. Urinal 11.50
Owner iling Address Suite Dishwasher 11.50
M V: e17-10 (o� Garbage Disposal 11.50
City/state Zip Phone
TI 6'c �h� r 7 LZ G — �(j� Laundry Tray 11.50
--
N e Washing Machine 11.50
Floor Dratn/Floor Sink 2" 11.50
Occupant Mailing Add Suite
3" _ 11...RrE
citylStete Zip Phone 4" 11.50
Water Heater onversion O like kind 11.50 I I C)
Na 4 Gas I In re u res a se erste mechanical permit.
MFG Home New Water Service 32.00
Contractor Mallin Address Suite MFG Home New San/Storm Sewer 32.00
L `,L'J t Lam' Hose Bibs 11.50
Prior to permit CI /State ZI Phone Roof Drains 11.50
Issuance,a copy - - �� OIC_ 7 2 7L(L,
of all licenses are Or n Consl.Cont.Board Lic.# Exp Dat Drinking Fountain 11.50
required If ��� t f JC Other Fixtures(Specify) 15.00
expired In COT Plumbing Lic.# 7 Exp.D to
database !� `I
Name
Architect Sewer•1st 100' 38.00
Or Mailing Address Suite Sewer-each additional 100' 32.00
Efl ineer Clty/State Zip Phone Water Service-1st 100' 38.03
0 Water Service-each additional 200' 3200.
Describe work to be done: Storm 6 Rein Drain-1 sl 100' 38.00
New O Rppair O Replace with like kind: Yes O t0
Residential& commercial O Storm b Rain Orate•each additional 100' 32.00
Additional description of work: — Commercial Back Flow Prevention Device 32.00
Residential Backflow Prevention Device' 19.00
Catch Basin 11.50
Are you capping,moving or replacing any fixtures? Insp of Existing Plumbing or Specially Requested 50.00
Yes O No Q1- Inspectionsper/hr
If yes,see back of form to indicate work performed by Rain Drain,single family dwelling 4.5.00
fixture. FAILURE TO ACCURATELY REPORT FIXTURE Grease Traps 11.50
WORK COULD RESULT IN INCREASED SEWER FEES.
I hereby acknowledge that I have read this application,that the information QUANTITY TOTAL OJ
given is correct,that I am the owner or authorized agent of the owner,and Isometric or river diagram is required 0 Quantity Total Is ,9
that plpns submitted are in com Ilan th OregormState Laws. 'SUBTOTAL
81 ne of w r t Data
tl"7- U 1, 11-66 8%SURCHARGE c�
Con t Person Namy - 04 a _
t t t I r 1 . 1 , ',,v + , -' PLAN REVIEW 25%OF SUBTOTAL
1 BATH HOUSE$178.00 i Required only If twure qty total Is>9
2 BATH HOUSE$250.00 — TOTAL
3 BATH HOUSE$205.00 7
(This foe Includes all plumbing fixtures In the dwelling and the first 'Minimum permit tea Is$50 4 8%surcharge except Residential Backflow Prevention
1110 foot of eanitory sower storm sewer and wafer asrvlco) Device which is$25 4 e%surcharge
All Now Commercial Bulldings require plans wrth Isom. is or riser diagram and
plan review
11 StOormslplumapp dor I./I M49
PLEASE CQMP;�ETE:
Fixture TypeV r Quan#its,; by Work Performed _
F—in --�— _ New _ Ma✓ed Replaced emR oved/ -a
Aped
ory _ _ _ - ---- ------__—__
r Tub/Shower Combination - --- —_
er Only Closet ---- - - _
Urinal —
Dishw_asher — - ---- _
Garbage Disposal ___
Laundry P,00_m Tray -- ---— —
Washing Machine --_ -- —. - --
Floor Drain/Floor Sink 2" --
------- — --3, -- - - - -
- 4„ --
Water Heater _
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE: y -
I We15f04mMP1umePP doc 12117199
CITYOF T I G e R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00082
13125 SW Ha!I Blvd., Tigard, OR 9.7223 (503) 639-4171 DATE ISSUED: 03/14/2000
PARCEL: 2S111 8D-00411
SITE ADDRESS. 14965 SW 96TH AVE
SUBDIVISION: DARMEL NO. 3 ZONING: R-3.5
BLOCK: LOT: 031 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USF- SF UNIT HEATERS: VENT FANS-
OCCUPANCY GRN: VENTS W/O APPL: 1 VEN1' SYSTEMS: 0
STORIES: B_OILERS/COMPRESSORS _ HOODS:
FUEL _TYPES 0 - 3 HP: i DOMES. INCIN:
3 15 HP. COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYE-ZS:
FURN < 100K BTU: 1 AIR HANDLING UNITS _ OTHER UNITS:
FURN >=TOOK BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Conversion of oil furnace to gas furnace to 100,000 BTU, vent not included in appliance permit, and gas piping
for new furnanr,and gas water heater.
Owner: FEES
KIMBERLY ZENZANO Type By Date Amount Receipt
14965 SW 96TH PRMT KJP 03/14/20( $50.00 0000647
TIGARD, OR 97224 5PCT KJP 03/14/20( $4.00 0000647
Phone:503-684-9057 Total $54.00
Contractor:
ENERGY MASTERS HEATING+ A/C
7470 SW 76TH
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Gas Line Insp
Phone:244-8880 Gas Line Insp
Reg#:LIC 000585 Heating Unt Insp
PLM 26-476PB Misc. Inspection
Final Inspection
ORIGIIVAL
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. 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- 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 952-001-0080. You may obtain copies of these rules or direct questions to IJNC by
calling (503)246-918 r l
Issue By:
Permittee QjLLrnq.� Permittee Signature:
Call (503) 6394175 by 7:00 P.M. for Inspections needed the next business day
Plan Check#,
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SON HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(603) 639-4171, x304 Date to DST
Print or Type Permit# 14 KC IQOQ-G?xJPL
Incomplete or illegible applications will not be accepted Called
T Name of DevelopmentlProted _ Description
Table 1A Mechanical Code _ _ Qty ce Amt
A Permit Fee
Job Street et Adsuhe# 15.00
��� �\ 1) Furnace to 100,000 BTU
H`l
Address l d `J -.l . Including ducts&vents see footnote 1,2 9.65 5
Bldg# ciiy/stete Zip 2) Furnace 100,000 BTU+
722 including ducts&vents see footnote 1,2 _ 1200
Name(or name of business) 3) Floor Furnace
Owner t YVt 1 ) , V -7-,- f1Z X11 C, Includingvent see footnote 1,2 9.65
- - 4) Suspended heater,wall heater
Mailing Address �) or floor mounted heater see footnote 1,2 9.65
y q L.,L� `-'�" � �tit 5 Vent not included in a pliance ermit 4.75
C /State Zip Phone Check all that apply,: 'Boiler Heat Air
For Items 6-10,see or Pump Co�nd Qty Price Amt
footnotes 1,2 Com
Name name of business)
V t VI,�.1 eV I '7 e `AZ JV`L 6) bsorb unit to
t- 40 1000KK BTU 9.65
Occupant Mailing Address 1)3-15 HP;absorb unit
Iiq �,CJ �_��) rj L,+-1I 100k to 500k BTU 17.65
yl tateZip Phone 8)15-30 HP;absorb
7� Ii�4 `1G S' unit.5.1 mil BTU 24.15
9)30-50 HP;absorb
Contractor Name unit 1.1.75 mill BTU 36.00
L ) 1c"V - �lt S} - Y 10)>50HP;absorb unit
>1.75 rnil BTU 60.15
Prior to permit
Mailing Addrew -
issuance,a copy 7 �' �'V, ���'� 11 Air handling unit to 10,000 CFM 7.00
of all licenses CMy/stater� / �y Ip Phone _
are required if 7 U� 1 z :1 s��Sl- 12)Air handling unit 10,000 CFM+
expired in COT Oregon Const.Cont. rd Lic# Exv Daills 11.75
database �� �� � ( f7 13)Non-portable evaporate cooler
Architect Name 7.00
14)Vent fan connected to a single duct
4.75
Or Mailing Address
15)Ventilation system not Included in _
____ a liance permit 7.00
ip
Engineer CRY/Stale ZPhone 16)Hood served by mechanical exhaust
7.00
Describe work to be done: 17)Domestic incinerators
1200
New Opair O Replace with like kind: Yes ONO r` 18)Commercial cr industrial type incinerator
.25
Residential Commercial0 4840
19)Repair units
Additional Information or description of work. 8.40
20)Wood stove/gas FP/other units/clothe dryer/etc
7.00 _
NOTE: For Commercial projects only;Units over 400 lbs require 21)Gas piping one to four outlets
structural gas celcs See footnote 1 3.75
Type of fuel oil O natural gas LPG O electric O 22)Mcre then 4-per outlet each M15C
Minimi,m Permit Fee$50.00 SUBTOTALI hereby acknowledge that I have read this application,that the Information %SURCHARGE given is correct,that arfthe n6jr authors ed agent of PLAN REVIEW 25%OF SUBTOTALthe o merha ns u ittc a I i fa ce with Oregoi Sate Ia,N . Required for ALL commercial permits onl TOTAL
Sig turn of OwnerrAgent Date ___
Other Inspections and Fees:
I �F' 4 �i 1� `� 1. Inspections outside of normal business hours(mininum charge-two
Contact Person Name Phone hours) $60.00 per hour
2. Inspections for which no fee Is specifically Indicated (mirimum
_ charge-half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to
1. Provide full schematic of euisting and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour
2 Provide drawings to scale showing existing and propused mechanicei
units. 'Slate Contractor Boiler Cert,fication req-tired
- "Residential AIC requires site plan showing placement of unit
I\mechperm doc rev 02.14199
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection; Line: 639-4175BusiMST
Lire: 639-4171
Cate Requested- N/�X) AM BUP
PM ---SSSS-- —
Location OL �� �j�t� /],n Suit- -- BLD
Suite MEC I
Contact Person 'n —
—=�. r�S�Y Ph C ��O
Contractor �/ — PLM
Ph SWR
-__ _
BUILDING Tenant/Owner --
Retaining Wall ELC
Footing
Foundation Access: ELR
Ftg Drain
�!t FPS
Crawl Drain Notes:
Slab Inspection __._ SGN
Post& Beam - - SSSS-- --
Ext Sheath/Shear --- - - - - SIT _
Int Sheath/Shear
Framing
Insulation -
-SSSS--
Drywall Nailing - ---- -
Firewall
Fire Sprinkler --
Fire Alarm
Susp'd Ceiling
Root - -
Misc:
Final -- - _
PASS PART FAIL
LUMBING
Pos earn
-
Under Slab
Top out - - -
Water Service
Sanitary Sewer
Rain Drains -
irrd
5S PART BAIL -- --- -__-_
ANIC
Post eam - _-----
Rough In
- --- --
-_
Gas Line _
Smoke Dampers
_ I-r
PART FAIL - - --i
ELECTRICAL
Service -�--� -
Rough In
UG/Slab -
Low Voltage ----
_ -_-
Fire Alarm -
Final - --,
PASS PART FAIL
SITE -- .-
Backflil/Grading SSSS— -
Sanitary Sewei -
form Drain ]Reinspection fee of$
Catch Basin --____`requirad before next inspection. Pay at City ball, 13125 SW Hall Blvd
Fire Supply Line ( 1 Please call for reinspection RE
ADA -- ]Unable to inspect••no access
Approach/Sidewalk // ,I
Other Date �7 � QV -
Final -'7 -----_-_ Inspector
PASS PART FAIL _ Ext
DO NOT REMOVE this inspection record from the job site.