Case File j14115 SW -A ON
CL
J _
1:lrecotdsVnlcvo(fi ll\(a(-9clsV3uildincj.doc
0
w
J
u.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639417I
DatcRcqucsted: _( (c <. A.M. P.M._-- MST:
Location:— ly,S �.-
4_t6 �� _ BUR i
Tenant:_ Suite:_ Bldg: _ MEC:
Contractor: Phone: J 7 � PLM: _
Owner: Phone:
--- _ _ EI,R:
_ SIT:
I':UILDING BLDG(con_i_) PLUMBING � MECHANICALS ELECTRICAL SITF
Site i'osvlicant PosUl3catn Post/Beam Cover/Service Sewer/Storm
Footing Roof IlndFi/Slab Rough-In Ceiling Water i,ine
Slab Framing Top Out GLJ Line Rough-In IIG Sprinkler
Foundation insulation Sewer II(W/Duct Reconnect Vault
Bsntt Damp Drywall Storm ace Temp Service MISC.
Masonry Ceiling Rain Dram UG Slab
Shear/Sheath Fisc Spklr/Alm Crawl/Found Dr Ileat Pump Low'Jolt
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved N4 roved Not Approved Not Approved
FINAL FINAL C_ FINAL- FINA L FINAL
CL
F-
Y-
F-
rl Cnli for reinspection 0 Reinspection fee of 3 _ required before next inspection O Unable to inspect
InFpector: �� � > :s� _ Date:_ J� " / — .. page---of
CITY OF TIGARD
A
DEVELOPMENT SERVICES 4 {-, teml4.
13125 SW Hall Blvd., Tigard,OR 97223 (503)W4171
T '.7)
77'
--OCH -ph MCI: R--
OCH. . .
" . . . . . . URP
(I L.T
"PE Or' LISE. ITO 7 71 7nTE7�':7.1
'C�UPP'41k:Y ORP., R-1
n-R T.E*S. . . . . . . . .
'1,.1
1�4 TYPEC33-- Th M'
tD--,')TR I R UN T
nnn�
pa noml Rs�. 3T0VFq, .
PoEssumi. . 0 ".P. t7 nlyrnf�,.
alr'b' UNITTS-- W R HANIX T NIB 1If '1T'HFr3 UW
AN 100-M. STU: 0
••i•' +-;,
it
4 T H rl V F PRMT Z`r,. 00 121) 0:7/1 NqB
7 h—
Nrt 53T Jr,!qNc� a?"rl
It 51.bor-, I- 'k
approver piens. TIs perw w
Ritbir W dar5 tf i1sliance, Or if w, is t
Char 10 days. ITTENION-, 1reger 1---w -Epir-
ide psed by the Vtl"w
sit fortt, ir CAR 95P.�3 Vel@ th,
cc
LLJ
11"10"97 MON 10:49 FAX 309 598 1960 CITY OF TIGAM) IZO02
CITY OF TIGARD Plan check a�_ C'
/J
Mechanical Permit Application Recd Biii13125 SW NALLBLVC1, Commercial and Residential! Date Recd
TIGARD, OR 97223 Date to A.E. _
(503) 639-4t7l, x304 Oate to DST
Print or Type Pemtlt
Called r -
Incomplete or illegible applications will not be accepted
Name o eveblxnenV - -- - Description
Table 1M Mechanical Code OTY PRICE MIT
Job
Address 9w.e Aagn Suites A) Permit Fee I 0. -0- 10.00
/d5 sw. y a,/e_
Bld�e cxrrStaa alp 1.) Fumaue to 100,000 BTU 6.00
-- - Lr 1 a-AIli-A 1 OT include ducts d,vents
e{or name d business), 2) Furnace 100,000 BTU+ �� 7.50
Owner I U� 2!! including ducts&vents ~);
1� �� r
adnq traa
Aa ° 3.) Floor Furnace, 6.00
S Lv tr?I- V>r including vent
<. VFAAA Zp Phone 4.) Suspended heater,wall heater 6.00
I S Cr flour mounted heater
r name or baso etre) 5.) Vent not included in appliance permit 3.00
OccupantM°"req aaarye G) goiler or coni
p,heat pump,air cored. 6.00
to 3 HP:airsorb unit to 100K BUT-
P Pnane 7.) BiAer or ewnp,heat pump,air c and 11.00
3-`5 HP;absorb unit to 500K BTU" _
Contractor 8.) Boils,or comp,heal pump,air coed_ I&00
1530 MP,absorb uniLS-1 mil BTU-
Prior to permit Mailing AtIdrsss g.) Boiler or comp,heal Pump,air cond- 2250
issuance,a ropy 9 00 R he- S 1 S 1/1 ' 30-50 HP;absorb ur4 1.1.75mil H tU"' I
of 311 licenses carrsw a z4, Prime 10J Baiter or comp,heal purrlp,-m--r aond. 3750
are required if �j I >50 HP_ahsorb unit 1.75 mil BTU"
expired in COT Qr9on on .cart.noarn Iit t Ern Cate 11.) Air handling unit to 10,000 CFM I 4.50
database t-{ioq --- L( • ZI A I
Architect 'r'"1e 13.) Non-portable evaporate cooler 4.50
Or Aft0nq Andress 14.) Vent fan connected to a single dud 3.00
Engineer c"Wa(e zo Nnnne 15.) Ventilation system not included in 490
_ _� _ _ appliance permit _
Describe work New Addihon O Altolation O Rapa 16.) Hood served by mochenical exhoust 4.50
to be done ResidentialNon-residential 0
Additional Description of work_' 17.) Dorr�st•c incinerators 7 50
18.) Commercial or industrial it 30,M
Incinerator
F list ng use of 19.) Repair unT�
building or K mporty
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer•etc rr- - - -- -- 460
buildhtg jr property
22) Other units 4.50
Type of fuel•oil U natural gas LPG O eleclrtc O 23) Gas piping one to four outlets 2.00
I hereby acknowiledge that I have read this application,that the 24,) More than aper outlets(each) 50
information given is currect,that I am the runner or authorlted agent of
the owner,that plans submitted are in compliance with Oregon State QTY SUBTOTAL
ii laws _
Signature of OwnedAgant Vat@
'SU8Tp1'AL 3
F 5%SURCHARGE _
J -- --
.- Contact Person Name Phone AVAN REVIEW 25%OF SUBTOTAL •�
n
J i . imum TOTAL ZJrJ1 91
permit fel is S25+5%surchargehpmt Ase (nov 4
"R"idential A/C requires site plan showing placement of unit
CITY OF TIGARD
EXPENDITURE,REQUEST
This form is a multi-use form, Appropriate receipts and documentation must be attached to this
form. Approved request due Tuesday 5:00 PM to A/P for check3 by Friday(week opposite
payroll only),
VENDOR NO.: DATE: 03-10.98
PAYABLE TO : Polen CountryInc REQUESTED BY: Jim Duckett
4221 NE St Johns Rd Ste
Vancouver WA
98661
WUNCEI LANECIU4 EXPEWDITURES:
Date Description, Invoice No.,etc. Account No. Amount
03-10-98 98-303975 10-0000-451000 6.36
Misc fees to be refunded to
customer due to pre-written check
in excess of fees owing,.
_ 'I OTAL
Milc.agc 32.5 —�
APL'ROPRIATION BALANCE: AS OF: PURCHASING:
APPROVALS:
(IF UNDER$50) Section Manager/Professional Staff
(IF UNDER $2500) Division Manager
(IF UNDER $7500) Department Manager
` (IF UNDER $25000) City Administrator
(IF OVER$25000) Local Contract Review Board
w
J