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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: c I aL ://3��` 1 A.M. P.M. MST:
Location:_ f f[�(�' s(i(,� �✓'r}-} UE -- BUR _
Tenant:
++ Suite: Bidg: MFC:� '-C�-
Contractor: �.CxJ 1 P t-L.4 f'T C_. Phone: J,���G' ' •' PI.M:
Owner:—N),M2��� —1!,, _Phonc: _j�1 �� ELC:.
ELK: —
_ Sim
BUILDING BLDG(con't) PLUMBING 'ME CHAN)� ELECTRICAL SITE
Site Post/Bearn Post/Befun - o`�3eam GQ Cover/Service Sewer/SLim
Footing Roof Ilndhl/Slab Rough-In n 11 Ceiling Water l.inc
Slab Framing Top Out Gas Line C( *' Rough-In My Sprinkler
I oundation Insulation Sewer IIood/Duct� Reconnect Vault
lismt Damp Drywall ;'orm Furnace L Lex Temp Service MISC.
Masonry Ceiling Rain Thain A/C Cr �J UG Slab
Shear/Sheath Fire Spklr/Ahn Crawl/I ound Dr I lent Pump Low Volt
Approved Approved <171wvjiApproved Approved
Appr/Sdw[k Not Approved Not Approved Not Approved Not Appmved Not Approved
FINAL FINAL FINAL FINAL
CA) 17
LLI
Ii Call for reinspmlion D Reinspection fee of S` ,required before next inspection Q 1 lnable to inspect
Inspector:_ �__ XI/ Date:_ I 2 3...S' 1 Page of
CITY a F T I G A R D MECHANIT ICAL
PERM
DEVELOPMENT SERVICES PERMIT #. . . . . . . : M E'C97-0473
13125 SW Hall Blvd., Tigard,OR 97223 503)639-4171 DATE ISSUED: 12/0E., 97
PARCEL: 2S112CC-04700
SITE ADDRESS. . . : 15860 SW 80TH AVE
SUBDIVISION. . . . - BOND PARK NO. 3 ZONINGi R-12
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :075 JURISDICTION: TIG
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS- 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . . 0
OCCUPANCY GRP. . : R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : v2)
FUEL TYPES------------ 0-3 HP. . . . : 0 DOMES. INCIN: 0
.GAS 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
F. IRE DAMPERS?. . : 10-50 HP. . . 0 WOODSTOVES. . : 0
GAS PRESSURE. . . 50+ HP. . . . 0 CLO DRYERS. . : 0
NO. OF AIR HANDLING UNITE; OTHER UNITS. : I
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS. : I
FURN ) =100K BTU: 0 > 10000 cfm : 0
Remarks : Gas insert and piping
Owner-: FEES
JIM NARDI type amai.tnt by date t-ecpt
15860 SW 80TH PRMT $ i--,5. 00 JSD 12/02/97 97-301334
TIGARD OR 97223 5PCT $ 1. 25 JSD 12/02/97 97-301334
Phone #:
Contractor,: ------------------------------
COST PLUS HEriTING & AIR
7132 N FESSENDEN ST ----------------------------
$ 26. 25 TOTAL
PORTLAND OR 97203
Phone #: 286-2009
Req #. . : 000479
------- REWIRED INSPECTIONS --------
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municioal Code, State of Ore. Specialty Codes ani all other Mechanical Insp
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within 180 days of iss,jance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in DAR 952-00I-0010 through OAR 952 001 8080. You may
obtain copies of these rules or direct questions to OUNIC by calling
(503)246-9187.
Un
S s 1_1 e P y Permittee Signati-tre :.- de-3 rji,-
....................4.......4....................4..............4...................
Call 639-4175 by 7:00 p. m. for inspections needed the next business day
...........................f......................4-4..............................
Plan Check#
CITY OF TIGARD Mechanical Permit Application Recd Byer
131.25 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E._
(503) 639-4171, x304 Date to DST_
Print or Type Permit#
Called
Incomplete or illegible applications will not be accepted
Name of Development/Protect Description
Table 1A Mechanical Code CITY PRICE AMT
Job Street Address Su tea A) Permd Fee -0- -0- 10.00
Address 15"�SrsQ 5 w gC�
Bldgs c tyfState zip 1 ) Furnace to 100,000 BTU 6.00
t t A 4' f f 7 z 1 including ducts&vents
Name(or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner i lkt L_ IV tir-Q i including ducts&vents
Mailing Addressr` 3.) Floor Fumace 6.00
I ') .y 4 t S V AJC including vent
citylstate zip Phone 4.) Suspended heater,wall heater 6.00
z ,y 6 Zc •r b 3 1 or floor mounted heater
Name(or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp,heat pump,air cond. 6.00
to 3 HP;absorb unit to 100K BIJT" _
C ryfstate Zip Phone 7.) Boiler or comp, heat pump,air Gond. 11.00
3-15 HP;absorb unit to 500K BTU-
Contractor Name 8.) Boiler or comp,heat pump,air Gond. 15.00
•qtr 1,.. jkiiL C.- I IJw , Pl 4 h k A,rz 15-30 HP;absorb unit.5-1 mil BTU"
Prior to permit Malang Address 9.) Boiler or comp,heat pump,air Gond. 22.50
issuance,a copy 11 11 a t`<g t n bt"•' 30-50 HP;absorb unit 1-1.75mil BTU"
of all licenses City/State Zip Phone 10) Boiler or comp,heat pump,air Gond. 37.50
are required if �'10 r1 7A-0 1�_I? Z. 1 >50 HP;absorb unit 1.75 mil BTU"
expired in COT Oregon Cunst.Cont.Board LieJ Exp.Date 11.) Air handling unit to 10,000 CFM 450
_database /7�!7 tf j', • ; �Jr1
Architect Name 13.) Non-portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer Zip Phone 15) Ventilation system not included in 450
appliance permit
Describe work New O Addition O Alteration'rn Repair O 16) Hood served by mechanical exhaust 1.60
to be done Residential O Non-residential O
Additional Description of work. 17) Domestic Incinerators 750
18.) Commercial or industrial type 30.00
ri5a; t ✓ #, kc at )��v+} r`�r ,�aep Incinerator
Existing use of 19.) Repair units 4.50
budding or property
20) Wood stove 4.50
Proposed use of 21 ) Clothes dryer,etc. 4.50
budding or property
22) Other units 4.50
N Type of fuel-oil O natural gas LPG O electric O 23) Gas piping one to four outlets r 2.00
I hereby acknowledge that I have read this application.that the 24) More than 4-per outlets(each) 50
J information given Is correct,that I am the owner or authorized agent of
the owner,that plans submitted are In compliance with Oregon.State QTY SUBTOTAL
e laws
Signature of pwnerlAgent Date 'SUBTOTAL
Al
5%SURCHARGE
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
eZ r�G C D� T TOTAL r "
i Vnechpmt.doc (rev 9 'Minimum permit fee Is$25+5%surcharge
"Residential A/C requires site plan showing placement of unit.
CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hah Blvd.Tigard,Oregon 97223.8199 (503)839-4171 PLUMBING PE=R11 I T
PER1y1IT #. . . . . . . : R'LM9i*• 014:
639--417.1 DATE ISSUED: 07/19/94
PARCEL.: 2S 1 1 cCC•--Q14'700
SITE ADDRESS:). . . : 15860 SW BOTH AVEC
SUBDIVISION. . . . : BOND PARE: NO. 3 ZONING: R--1
BLOCK. . . . . . . .. . . . LOT. . . . . . . . . . . . . :7
CLASS OF WORK. ALT GARBAGE DISPOSALS. . : MOBILE I. Oly1EW GPACEc,.
TYPE OF USE. . . . :SF WASHING MACH. . . . . . . : BACKFLOW PRE:VNTRG. . : 1
OCCUPANE'r' GRP. . :R3 I"LOOK DRAINS. . . . . . . . TRAPS. . . . . . . . . . . . . . .
STORIES. . . . . . . . . WATER HEATERS , . CATCH
FIXTURES------ LAUNDRY TRAYS. . . . . . : SF RAIN D RA I N5. . . . .
91 NKS. . . . . . . . . . . URINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . . .
LAVATORIES. . . . . : OTHER FIXTURES. �, — . I
JUS/SHOWERS. . . . : SE=WER LIN;_ (ft) . . . .
WATER CI_OGETS. . : WATER LINE ( ft ) . . . .
DISHWASHERS. . . . : RAIN DRAIN (ft ) . . . .
Remarks : BACK FLOW DEVICL
Owner-: —.__._______.____._.____.__..___ __.._...__________._.__.__.__.__.__. ____._ FEES
JI11 NORDI type amotint by date r,ecpt
15860 SW 60TH PRMT $ 15. 00 5W 07/19/94 -
5PCT $ 0. 75 SW 07/19/94
'TIGARD OR 97223
Phone #i: ` `,''\
Contractor,: -
SUPERIOR LANDSCAPE INC.
P. 0. BOX 355
TUALATIN OR 9706
V11-Ione #: $ 15. -75 TOTAL
Req #. . : 6315
_______ REQUIRED INSPECTIONS ---___
This perait is issued subject to the regulations contained in the RP/Backflow Pr-ev
Tigard Municipal Lode, State of Dre. Specialty Codes and all other final Inspection
applicable laws. All Mork will be done in accordance with
approved plans. This perait will expire if work is not started
CL within 180 days of issuance, or if work is suspended for sore
t than IAO days.
J F'ermit: tew5 :3i gnati.tr•e :
1 s s,u e d LAY
Call for, inspection - 639-4175
City of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. # _
13125 SW Hall Blvd. Permit # -
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
N..of- •^1 New Single Family Residences Ong
❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Job g. L. (��h ❑ 3 BATH HOUSE$225.00
Address , s,n. za Fee includes all plumbing fixtures in the dwelling and the first 100 feet
CAL of water servi e, sanitary sewer and storm sewer. See fees below.
N.- .10-1-) FIXTURES QTY PRICE AMT
L �ti 1\.J IL.,) > Sink 9.00
M•�° �• Ph•^• Lavatory 9.00
Owner Tub or Tub/Shower Comb. 9.00
cM�an. no Shower Only 9.00
Water Closet 9.00
f'u'^•+^ ^•m•^f •••+ Dishwasher 9.00
Garbage Disposal 9.00
Occupant MM+°,,,,„• ,aH Washing Machine 9.00
Floor Drain 9.00
WSW. zr Water Heater 9.00
Laundry Roor,1 Trey 9.00
N. II Urinal 9.00
U Lk;_1L I k""'_ l w 1 1, .x ' '+ ' Ctner Fixtures (Specify) 900
M.r u Ana.,. fig. 9.00
Contractor ) 1
� - L�. `J u`x. �� � 9.00
Willa" Lv 9.00
i f� -1 + r`i l_,L L+ \1V' L Sewer 1st 100' 30.00
R.OtMW N.. Car E-A.T.Ne. Sewer-ea. Addit. 100' 25.00
(, ��C-, ) 1, i, ) Water Service 1st 100' 30.00
1 hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00
information given is correct, that I am the owner or authorized agent of --
the owner. that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30 W
I am registered with the Construction Contractor's Board, that the Storm &Rain Drain Addit. 100' 25.00
number given is correct, (If exempt from State registration, please
give reason below.) Mobile Home Space 25 00
Back Flow Prevention
Device or Anti-Pollution Device 9.00
•.<• .,.�M.°•^n af• Any Trap or Waste Not
Connected to a Fixture 9.00
Describe work new addition O alteration repair Q Catch Basin 9.00
to be done residential 0 non-residential v Insp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40 0011ir
Existing use of
building or property Rain Drain, single family dwelling 30.00
-L Residential backflow prevention -
�' devices 15.00
A
L Proposed use of
H building or property
,_.. "(Except residential backflow
prevention devices)
cz
xD NOTICE 'Minimum Fee $25.00 SUBTOTAL
111
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PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5% SURCHARGE
CONSTRUCTION OR WORK,IS SUSPENDED OR ABANDONED
FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS
COMMENCED PLAN REVIEW 25% OF SUBTOTAL
TOTAL
Special Conditions _
__ Date issued �- ,�_ 1� by
IIV�i! J it, 11 fit ;4IN'llif r I I ISIO
N . 1.0
1341-A-l', 11111-111-IN 1 1 3.1 50
i;p(,Ii jIII()IIP4r 0. W.10
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PAID y31.
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/ STATE OF OREGONI:
LICENSED LANDSCAPE CONTRACTORS BOARD i
AS: NO.: 11958
ALL PHASE$
PLUS BACKFLOW
LUSSIERr ROBERT M
PO BOX 355 .'
TUALATINi' OAR 9*06� Oo
i EXPIRES:
04/30/95
STATE OF OREGON ,
LICENSED L3INASCAPE CONTRACTORS BOARD
AS: NO.: 6315
LANDSCAPING BUSINESS NON-EXEMPT
ALL PHASES
SUPERIOR LANDSCAPE INC (ay: �� CI Q''
PO BOX 355. 1'
TUALATIN• OR 9706210000
EXPIRES:
01/31/95
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