12945 SW 135TH AVENUE �D
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12945 SW 135"' Ave
CITYOF T I G A R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT$$: MEC2001-00318
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/10/01PARCEL: 2S104BD-02700
SITE ADDRESS: 12945 SW 135TH AVE
SUBDIVISION: VISTA LAKE ZONING: R-7
BLOCK- LOT: 00.:1 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN- EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OC:UPE.IlCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
.TORIES: BOILERSI_CO_MPRESSORS HOODS:
FUEL TYPES_ 0 3 HP: DOMES. INCIN:
VVOIJ !^ 3 15 HP: COMML. INCIN.
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: 1
GAS ?RESSURE: 50 + HP: CLU DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS.
> 10000 cfm:
Remarks: Installation of woodburning insert (no surround).
Owner: _ FEES _
MAY, RICK V Type By Date Amount Receipt
12945 SW 135TH AVE PRMT CTR 9/10/01 $72.50 272001000C
PORTLAND,OR 97223 5PCT CTR 9/10/01 $5.80 272001000C
Total $78.30
Phone:
Contractor:
TOM BISHOP CONSTRUCTION
11525 SW CANYON
BEAVERTON, OR 97005 REQUIRED INSPECTIONS_______
Woodstove Insp
Phone:503-6264652 Final Inspection
Reg #: LIC 00054696
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
pians. This p ymit will expire if work is not started within 180 days of issuance, or If work is suspended
for more then 1.30 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notificatiol Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0080.�,Yr-'J may obtain espies of these rules or direct questions to OUNC by calling
i� �
n )9aF_a,� c� �
Issue By: Permitter Signature: L.5) 1
Call (503) 639-4175 by 7:00 P M. for inspections needed the next business day
Mechanical Permit Application
Datereceivedy'
City Of 'Dgar � N! 41p�t Projeedappl.no.: Expire date:
CiryoJTi�ard Address: 13125 SW Ha J, igar ;OR 972 .
Phone: (503) 639-4171 Date issued: Bye{rJ Receipt no.:
Fax: (503) 598-1960 SF '7 2(101 Case file no.: Payment type:
Land use approval: _ Building permit no.:
1
;kI &2 family dwelling or accessory U Commerctallindustr,al U Multi-family U Tenant improvement
U New construction CJ Additinn/alteration/relaaccnu nt U Other:
JOgSITE INFORMATION
Job address: 4Q ' L�S J k) /.• C /. IwAlcate cyuspment quantities in boxes below. ladicate the dollar
Bldg.no.: _ _ Sttite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax Iol/account no.: profit.Value$
Lot: Block: Subdivision: *See checklist for important application information and
Project name jurisdiction's fee schedule for residential permit fee.
City/county: '•— MKIll!J11'lux
�j Ort ---^=I1': ! �� �,
1114114111
Description and location of work on prenli/ccs: N 1FJIOIII
iU1ti{.tt- — j u yrgW►j Fee(ea.) Total
Est.date of completion/inspection: UrxrilNion Qt . Rcs.only
Res.osal
Tenant improvement or change of use:
Is existing space heated or conditioned'?U Yes U No Air handling unit CFM
Air conditioning(site an required)
Is existing space insulated?❑Yes U No aaaar tenuon o existingsystem —
oi er compressors
Business name:p yin r s leio 0011 S o u /01, / F,r e 9 State boiler permit no.:
C.. HP --Tons BTU/H
Address: �zq yta. o it smo c amper uct smoke detectors
Cit �q u♦ 10 _ Sratc:00 ZIP: ?700 cat (site plan required)
Phone: Insta rep acciurnace urner ATO/
t In
ductwork/vent liner O Yes O No
nsta rep ac re ovateeaters--suspen e ,
City/metro lic.no,: -� wall,or floor mounted
Name(please print):7Q -v-i Zi' J I Vent fora ance other than furnace
PERSONCONTACr e gent on:
Absorption units BTUA I
Name: Q P r 1 -i;.� Chillers___ HP
Address: �S ( JkA I a Compressors HP
City y{`f U v� Statc: / z1P; OUS .nv ronmenta ex uct and ventilation:
e 7 Appliance vent
Phone: i;(o.l .1 Fax' / F-mail: )r erex aust
Hoods,Type]/ res. uc a azmat
hood fire suppression system
Nanic: �'<< C Exhaust fan with single duct(bath fans)
Mailing address: aunts stem a art ftom heating or ---
Cit ue piping an rn ut on(up to outlets)
Q'.t State: 'LIP: T LPtJ NO Oil
Phone: a'77 Fnx: _ E-►nail: ue�+p n each additional over 4 nut els
Procorspiping(sc ematicrcquire )
Name: Number of outlets
pplT�nce or equipment:
Address: Decorall ve fireplace
City: Si Ir: 7.1 P: tsert-type � ^_ _
Phone: [i•rtlai , oo stove�iictslove _
Applicant's si twe d� •_,/ Other:
Name (print):'
Na all jurirdkiions accept credit suds,please cats jurisdiction frx mme infornmion. Permit fee.....................$ --_-
O Visa O MasterCard Notice:This permit application Minimum fee................$
credit card number ��� expires ifs permit is not obtained Plan review(at _ %) $
within IRO days eller it has been State surcharge(8%)....$
NA1W07'cW&kier u s owTi non cm1l c rd accepted as complete.
_ s TOTAL .......................S
-- —Cr�h+�I&r si nature AmuuM
44046I1(6000M)
C!TY OF TIGARD BUILDING INSPECTION DIVISION MS.,.
24-Hour Inspection Line: 639-4475 BusiAess Line: 639-4171 --
BUP
_ Date Requested^ 7 /� AM_ PM -_— BLD
Location 1 �1�l ! -� Suite MFC
Contact Person Ph PLM
Contractor Ph SWR —
BUILDING Tenant/Owner ELC _
Retaining Wall ELR
Footing Access: W
Foundation FPS —
Ftg Drain SGN
Crawl Drain Inspection Notes: -- ----- ---
Slab SIT
Post&Beam -------`
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing _ �_-
Firewall -- -�
Fire Sprinkler --_ __-_ -------_---
Fire Alarm
Susp'd Ceiling
Roof
Misc: -- - — -- ---
Final
PASS PA.-.. FAIL - --- -- - — - —
PLUMBING
Post$Beam -`- - ---
Under Slab
Top Out -- — -
Water Service
Sanitary Sewer
Rain Drains
Final --- - --- ----- - -
PASS PART FAIL
MECHANICAL - .--- -- --- - -- -------
Post&Beam -- -- - - - --
Rough In r1 L,cel
Gas Line
Smoke Dampers.
fww-
PART FAIL
ELECTRICAL – –�–�— -
Service
Rough In -.`-----------_ —_-,—• ----•---
UGiSlab - -
Low Voltage
Fire Alarm
Final
PASS PART FAILSITE
Backfill/Grading - --` ---- --
Sanitary Sewer
Storm Drain ( j Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( j Please cell for r Inspection RE. ( j Unable to inspect-no access
Fire Supply Line
ADA
App;oath/Sidewalk7
Other Date 1 Inspector`- Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.