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11058 SW 81ST AVENUE
3 O Ln 00 C� C 00 D m Z c m 11058 SW 0151 AVENUE CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 MST INSPECTION DIVISION Business Line: (503)639-4171 BLIP _ deceived _�_`��"� --- Date Requested_4.7.._....-_— AM ^._-- PM— BLIP --- -- Location _.���� Zt_ -_�� �1 `—. Suite MEC _ __..------ Contact Perscn -_ Ph O _aJ-, PLM __..----_.--- -----..----- Contractor –__—_- __.____ Ph SWR BUILDING Tenant/Owner —. ELC Footing ELC Foundation Access: - W Ftg Drain ELR _— Crawl Drain — Slab Inspection Notes: SIT Post&Beam Shear Anchors Ext Sheath/Shear - Int Sheath/Shear Framing --- ---- — Insulation Drywall Nailing — -- - Firewall Fire Sprinkler --- - - - -- - -- - - -- Fire Alarm Susp'd Ceiling - — -- - -a---- - -- - Roof Other: - ------ - Final PASS PART FAIL -- - - -- -- ----- - - PLUMBING Post&BeamW ----- J.-- -- Under Slab -- — - - Rough-In Water Service Sinitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: - --- - - — Final PASS PART FAR -- ---- -- - -- MECHANICAL - Post&Beam Rough-In — —---- Gas Line Smoke Dampers Final PASS PART FAIL -------- -- `— --- --- —"' — ELECTRICIL UG/Slab Low Voltage __— F larm umnaw— F] A8 PART FAIL u Reinspection fee of$_— required before next inspection. Pay at C4 Hall, 13125 SW Hall Blvd. SIT ❑ Please call for rkiinspection RE: —___— Unable to Inspect-no access Fire Supply Line ADA c� _'? Approach/Sidewalk Dab_,/ �-_S__ 6� Inspector7�_ 6 - =thejo -Ext _ Other: Final – DO NOT REMOVE this inspection record Ir . PASS PART FAIL wowawwwr�� CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2003-00472. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/703 PARCEL: 1 S136CB-08700 SITE. ADDRESS: 11058 SW 81ST AVE SUBDIVISION: HERB + PEGGY'S PLACE ZONING- R-4.5 BLOCK: LOT: 027 JURISDICTION: TfG CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS WHO APDL: VENT SYSTEMS: STORIES: BOIL.ERSICOMPRESSORS HOODS•. _ FUEL TYPES - 0 3 HP 1 DOMES. INCIN: FP__— ----- 3 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNrr5: FURN >=100K BTU: « 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: '.nstallation of new gas furnace,gas piping, venting and duct worl,. ncv it r unit Owner: — HEATHER REYNOLDS Description Date Amount 11058 SW 81 ST AVE �NI1 (111 Permit Fee 8/7/03 —` $72.50 TIGARD, OR 97223 IIAX18",,StateTax 83/03 $5.80 Total $78.30 Phone: 503-645-0986 -- -- Contractor: ALL METRO HEATING INC PMB 120 2870 NE HOGAN RD STE E GP ESHAM, OR 97030 REQUIRED INSPECTIONS _ Pho ie: 503-381-4557 Gas Line Insp Heating Unt Insp Reg #: LIC 152937 Cooling Unt Insp Final Inspection 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 952-001-00 i Issued 13y: Permittee Signature: �- Call (503) 639-4175 by 7.00 P.M. for inspections needed the next business day eE Mach nieal Permit Application Received � Mechanicr1 1. Date/B G' Permit No.: ' )W' 72- City72- City Of Tigard Planning ApprovalBuilding g Date/By. Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: . Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land Use Date/By: Case No.: Irternet: www.ci.tigard.or.us Contact sec Page 2 for 24-hour Inspection Request: 503-639-41'15 Name/Method: J i Supplemental Information. TYPE OF WORK _ COMMERCIAL FEE*SCHEDULE-USE CHECKLIST ❑ New construction ] Dernoli',it.rn Mechanical permit fees'are based on the total value of the work Addition/alteration/rep lace_ment Other: performed. Indicate the value(rounded to the nearest dollar)of all -- CATEGORY OF CONSTRUCTION mechanical materials,equipment,labor,overhead and profit. 1 &2-Family dwelling Commercial/Industrial value: s 46.1 S-, 01" See Page 2 for Fee Schedule Accessory Buildinb ❑ Multi-Fames-s RESIDENTIAL E UIPMENT/SYSTEMS FEE'SCHEDULE Description t Fee a. Total ❑ Master Rudder Other: _ _ Heatin Coolin JOB SITE INFORMATION and LOCATION Furnace-add-on air conditionin •' 1 14.00 1 •°i' Job site address: 1!o VS <w 81 ib A„a.__ Gas heat pump _ _ 14.00 Suite#: Bld ./A t.# _ __— Duct work / 14.00 V. "° Project Name: H dronic hot water system 14.00 Residential boiler Cross street/Directions to job site: 06 a (for radiator or h dronic system) 14.00 +n Q6 r!• E, o °i 9 w he 8*I- A•va... AJ, oUnit heaters(fuel,not electric) 184. A v4 +a P�'.P71,�. W, e, �Fa.�'►'t� �a 8114 in wall,in-duct,suspended,etc. 14.00 °a S 1 c F AJ A k-Q P.&6 d I%,-A 16 Flue/vent for any of above / 10.00 /a. Lot#: Repair units _ 12.15 Subdivision: _ Other Fuel Apl iliancd Tax map/parcel #: _ Water heater 10.00 DT�SCRIPTION OF WORK Gas fireplace 10.00 ,,cl / �. ,- „� ! /o f t► a•JTgapr Flue vent(Fater heaters fire luce) 10.00 Log lighter as 10.00 • �w.. i i nti �' t'^i r c*s11,"1 .+r-cr r'•< Wood/Pellet stove 10.00 r..-.C*, a. U LA 4 n•.� d�,.� ,�,I tt Wood fire lace/inscrt 10.00 _ Chimne /liner/flue/vent _ 1 10.00 PROPERTY OWNER TENANT _ Other: — 1 10.00 Name: 1.L r . �} — --- _ Environmental Exhaust&_Ventilation x• 1, Range hood/other kitchen equipment 10.00 Address: !.e 5"P� � �i_ }�4 _. Clothes dryer exhaust 10.00 City/State/Zip: , a . ,_O 2 e"-4- -L 3 _ Single duct exhaust Phone:i 1 b i 1 ,,S - o ,k ax: _ (bathrooms,toilet compartments, APPLICANT §JCONTACT PERSON utili!yrooms — 6.80 Attic/crawls ace fans 10.00 'at, �.. i a�•�. _ --_ _Name: — ! — v other 10.00 Address: Cl a/ _ ��.J GA T*� ��. !� 1� Fuel Pining City/State/Zip: Par 1 r L- r_+ _ •1S5.40 for flrst 4,51.00 each additional Furnace etc. / *• l: '_° Phone:(V,3) ;y 1- vi-r-7 Fax: —- -- Gas heat pump •• E-mail: Wall/suspended/unit heater _ CONTRACTOR Wnter heater Business Name: 1/ , M L 14a ,,. i--ci Fireplace — ••Range •* _Address: M�_�r� ��a �► ' ,. e4f BBQ Clty/State/Zip: o k "I :.04OUQ Clothes dr cr(gas) Phone: - Fax: S- J) 2 w 4. -o r z Other:-- -- — — - CCB Lir. #: r z 43 '11,P', F _ Total: y _ Mechanical Permit Fees* Authorized —_ Subtotal. Signature: _ Date: g ' — �— Minimum Permit Fee$72.50 $5 ` ' , Plan Review Fee(25%of Permit Fee (Please print name) State Surcharge L8%of Permit Fee _$ 6, qc, _ TOTAL PERMIT FEE S '7J 1 C Notice: This permit application expires ifs pernoi is not obtalned within 'Fee methodology set by TrWounty Building Industry Service Board. 110 days after It has been accepte l as complete. •'Site plan required for exterior A/f'units. i\hsu\Perrnit rotmts\MccPcrmitApp.doc 01/03 Mechanical Permit Application.- City of Tigard r Page 2 -Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: _ $1.00 to$5,000.00 Minimum fee$72.50 $5,001.00 to$10,000.00 $72.50 for the first 55,000.00 and$1.52 for each additional$100.00 or fraction thereof,to and including$10,U)0.00. $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and $1.54 for each additional$100.00 or fraction thereof,to and including S25,000.00. 525,001.00 to$50,000.00 $379.50 for the first$25,000.00 and $1.45 for each additional$100.00 or fraction thereof,to and including _ $50,000.00. 550,001.00 and up $742 00 for the first$50,000.00 and 51.20 for each additional$100.00 or fraction thereof. Assumed Valuations Per A� liance: Value Total Description: Qty (Ea) Amount Furnace to 100,000 BTU,including 955 ducts At vents Furnace>100,000 BTU including ducts 1,170 &vents — -- Floor furnace including vent 955 Suspended heater,wall healer of floor 955 mounted heater Vent not included in a liance rmit 445 it units _ _ 805 <3 hp;absorb.unit, 955 to 100k BTU 3-15 hp;abso,b.unit, 1,700 101 k to 500k BTU 15-30 hp;absorb,unit,501k to I mil 2,310 BTU -- 30.50 hp;absorb.unit, 3,400 1-1 75 mil.BTU _ >50 hp;absorb.unit, 5,725 >1.75 mil.BTU Air handling unit to 10,000 cfm 656 _ Air handling unit>10j000 cfm 1,170 –Non-portable evaporate cooler 656 Vent fan connected to a single duct 446 Vent system not included in appliance 656 permit Hood served by mechanical exhaust 656 Domestic incinerator 1 170 Commercial or industrial incinerator _ 41590 Other unit,including wood stoves, 656 inserts,etc. — Uas piping 1-4 outlets 360 Each additional outlet _ 63 TOTAL COMMERCIAL S VALUATION: _ i\Mts,,pe.rmit Fomu\MecPcrmitAppPg2.doc 01103 1 �y CITY OF TIGARD ELECTRICAL PERMIT PERMIT#: ELC2003-00560 DEVELOPMENT SERVICES DATE ISSUED: 9/9/03 13125 SW Hall Blvd., Ticiard, OR 97223 (503) 639-4171 PARCEL: 1S136CB-08700 SITE ADDRESS: 11058 SW 81ST AVF_ ZONING: k=1.5 SUBDIVISION: HERB+ PEGGY'S PLACE BLOCK: LOT : 027 .JURISDICTION: TIG Project Description: Install (2)branch circuits. _RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS_ 1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVCI FDR: 6014-amps -1000 volts. MINOR LABEL. (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR- 1 PER HOUR: 401 - 600 amp: EA ADD'I_BRNCH CIRC: IN PLANT: G01 - 1000 amp: _PLAN REVIEW SECTION_ 1 >000+ amp/volt: 4 RES UNITS �T > 600 VOLT NOMINAL_ I__ Reconnect onl SVC/FDR—225 AMPS: CLASS AREA/SPEC OCC:_ Owner: Contractor. HFA IHER REYNOLDS WESTERN CASCADE ELECTRIC INC 11()58 SW 81ST AVE 11867 SW WILTON AVE TIGARD,OR 97223 TIGARD,OR 97223 Phone: 503-645-0986 Phone: 503-521-0000 Reg #: F.LE 34-616C SUP 4625S FEES _ LIC 153416 Description Date Amount Required Inspections (EL.PRM'1'j F.Lc'Pcrnui 9/9/03 i$53.50�� ----�- [TA\IS",.State"fax 1)9 0; $4.28 RoughFinal_ Elect'/Final Total $57.78 I — 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 accordenoe 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 by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUMr.at(503)246.6699 or 1-800-332-2344. Issued B � / Permit Signature(", OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease,of rent. OWNER'S SIGNATURE: _ ___ ____ ___-_- DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. E; EC'N �_-_— —.__.._ __ DATE:_________—__.__-_._ LICENSE NO: _—____-_- ___ ___-- _. ----_--.- Call 639-4175 by 7:00pm for an inspection the next business day FlixtriuPermitApplication Datereceived: ;� .! �, Permitno..-- J City of Tigard Project/appl.no.: / Fxplre date: I'rtvnfTr,GnrCf Address: 13125 SW Ha Blvd.Tigard,OR 97223 Datcisaucd, S t Phonc: (503) 639-4191 __ Y' pt no.: Fax: (503) 598-1960 Case file no.: Paynrenttype: Land use O 1 &2 family dwelling or accesstaiy ❑Comme,cial,ndustnal 0 Multi-family 0 Tenant improvement ❑New construction ❑Ad(.I:tion/alteruticin/rcplacemont J Other. Q Partial lob addresv j 10 j� LA� flsL a f Bidg. no_ Suite no.: Tax map/tax lottaccount no.: Lot: f— Block Subdivision: Project name: _ I Description and location of work-on premises: Estimated daft,of completion/inslx"ction: CONTRAgOlk Jolt Doi Fee MM Bna1nC35 name: � 4 D"cri tion QtY. (e9) Tectal no.insp Address: Z 2 New revl"t[al-lineae or uw]6 earrat►per - dwel6oe aril.Includes attatbM gauagr. City: state-0/L ZIP: 7 L8-1 Sari«included: Phone:.5^L I-6 Oft) Fax: C2;).MW&mail: 1000 sq.P.or leu 4 Each additional 500 .R or portion thereof CCB no.. JS3 i ©ec.bus.lie.na 3 -G/GC Umitedenergy.residen al 2 Ci /metro lic.no.: N 3 E _ Limited energy`residential __ 2 -� Each msnufnctured home or modular dwelling Si urkA s^ddryising electrician(recuired) _ Date -L _ Serviceand/or feeder 2 Se elect.name(print)--),f Licence no: y�,s� cesorfeeders-{alta 1lRion,io ----- altemdoa or retocatioe: 200 amps or less 2 NarnC rint): 201 cups to 400 amps 2 Mailing address: - --- 401 amps to 600 snips — 2 -��� 601 amps to 1000 amps2 City: —1�S_tie: ZIP - over 1000 rm a or volts 2 Phone: Fu: &mail:^ Reoonnect3ly 1 Owner Installation:The installation is h,:tng made on pmpetty I own Temporary services or feeders Which is not intended for We.lease:, cent,or exchange according toinsullatrou,alterstion.orrelocatioe: ORS 447,455,479,670,701. 200 amps or las 2 201 amps to 400 amps 2 Owner's si re: Date: 401 to 600 amps 2 Melt elfc7tta-ueM,altefatton, ar qtr wslml per owl. Name: A Fee forbranch conics with purchase of Addt" _ service or feeder fee,coca branch circuit 2 ri • — �- State: T ra ZIP: _ B. Fa for nch circuits without purchase Phone: — Fax' �p)�l; of service or feeder fee:,first branch circuit: Mb ft 2 6wh additional branch circuit: w Ziff c.(sen orfeederam Ch1 )l ❑Cervlet ovrr2:.5 unpsnem,tlercial U Bath-camelactlity Each ump or irtigrtlon txrcle 2 Eachsi ncrouuine.li hum 2 U 5efvlcr ova 320 amps-sting of 1&2 0 Hazardous locanon g R_-�. family dwellings U Building over 10.000 square feet four or Signal circuit(a)or a limited energy panel. U System over 600 volts nominal more midcmuial units en one structum alteration,or extension• - - --- — 2 U Building over dwee stories U FTeadem 40J amps or more 4N.4cri on p paupers load over 99 peraxra O Manuradaed strrmearea at Rv park a adds021-%;gwdion orer� Mee ownhle to+mv nt tf,e alro•e: U pgmyylighdngplan U Other. ---- Per inspection r � — ®Iiwk_ ab orpbm WM my of the Albot e. r lnresugadon fee The above we not at�hle to tesy0ttlry COWAMCOM,cruise. Other Permit fee.....................$ 3 Sol an 1 �or&�p�cO►" don far mss lotamstlea Notit o:i f ai+ennitpernilti notication Plan teview(at — %) S O Visa �.MutwCard emrplrae if a permit a not obtained credo a ,lecher S W I 6 V S D COSI'_4. __� vviWln 180 Aeys eller h hoc beam State stucttarge(896)..,.$ 7 pp��r ...........S �' QS !- a l/#ti H V aoceptad as eontpirfr. roT� area � 440.4615(6 oM) C der aipt era Arouuot d Wdeo:EO C00r'_ b0 .daS 92.80 TES COS: 'ON Xdd a I a1a313 3atIOSdD N831S3M: W08J