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11640 SW 95"' Avenue
Ci i N OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business line: 639-4171 BLIP
_Date 'Requested__ _ _--AM --PM BLD
Location � `� -� Al./`–'e-- Suite MCC G a 1 D U r3�
Contact PersonPh ` G5 PLM
Contractor ^_ _ -- Ph --_ SWR
BUILDING Tenant/t er, _ I I u ELC
Retaining Wall �� �' - ..5 ELR
Footing Cces FPS
Foundation
Fig Drain SGN
Crawl Drain InspeC on Ngtes:
Slab �--I-- / —`"------t--- --- 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 PAP' FAIL.
PLUMBING --_— —
[lost& Beam
Under Slab - -- --
1 op Out
Water Service
Sanitary Sewer
Rain Drains —
Final
PASS_ PART FAIL -- - --__- -—
MECHAWCAD
Post& Beam
Rough In _-.—
Gas Line -
Smoke Dampers —
PART FAIL
ELECTRICAL
Service —
Rough In
UG/Slab - — —
Low Voltage
Fire Alarm
Final _
PASS PART FAIL -�
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain ( J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin ( Please call for reinspection PF -.__ — ( J Unahle to inspect-no access
Fire Supply Line
ADA
Approach/Side walk Date l �� a,)2_.._ Inspector __ _ _Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
'� CITY OF TIGARD MECHANICAL PERMIT
PERMIT#: MEC2001-00439
a
DEVELOPMENT SERVICES DATE ISSUED: 12/5/01
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S135DC-03300
SITE ADDRESS: 11640 SW 95-i H AVE. ZONING- R-4.5
SUBDIVISION: F1RDALE JURISDICTION: TIG
BLOCK: LOT:
P COOLERS:
CLASS OF WORK: OTR FLOOR FURN: EVAVENT FANS:OF USE: SF UNIT HEATERS: VENT SYSTEMS:
OCCUPANCY GRP: R3 VENTS W/O APPL: HOODS:
STORIES: BOILERS/COMPRESSORS
cl_ ES 0 - 3 HP: DOMES. INCIN:
FUELTYPES- � 3 - 3 HP:
MAXCOMML. INCIN:
15 - 30 HP:
MAINPUT: BTU REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 i- HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: e= 10000 cfm: GAS OUTLETS. 1
> 10000 cfm:
Remarks: Installation of new gas furnsce and gas line.
� FEES__
TRAPP,'VVARREN L HELEN W Type By
Date Amount Receipt
11640 SW 95TH AVE PRMT CTR 12/5/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 12/5/01 $5.80 2720010000
Total $78.30
Phone:
Cont---'--'
FIRST CALL HEATING & COOLING
1650 NE LOMBARD REQUIRED INSPECTIONS
PORTLAND,OR 97211-4798 -�
Gas Line Insp
Phone:231-3311 Heating Unt Insp
Reg#:LIC 102030 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code,
State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001�t7tS80. Ypu may ob ain copies of these rules or direct questio s to OUNC by calling
;� � p
rqn,Aja -cap q
Issuevr; f
Permittee Signature:
y:
Call (503)839-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit A li a-
_ ECEN-MUUate:cceivc�: ?d/ Permit no.:
City of Tigard Project/appl.na.: Expiry;date:
"ityol Ti and Address: 13125 SW Hall Blvd,Tigard,OR 9722
Phone: (503) 639-4171 y;i. % 2001 Date issued: By: Receipt no.:
Fax: (503) 598-1966 *Llai Y�U1kn 11(JA W Case file no.: Payment type:
1.:1(t(�use anproval: _ �{1L4+��U LM910N Building permit no.: —
TYPE OF PERMIT
la I &2 fancily dwelling or accessory U Commercial/industrial U Multi-family U Tenant improvement
U New construction 1 d Addition/alteration/replacrmeul U Other:
1 { SITFI�k_PRMATION1 1
Job address: ��_ % , 'i i�/ Indicate equipment quantities in boxes below.Indicate,the dollar
Bldg.no.: _j Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax ma tax lot/account no.. _ profit Value$ _
Lot: Block: Sub liv_i_sion: *See checklist for important application information and
Projeelname: jurisdiction's fee schedule for residential pennit fee.
City/county_: _L_� , ZIP: 6/ ' t
Description and location of work oq premises: ,- t y l
/i i ; Fee(ea.) Notal
I'st.dal o rttpletion/inspu tion: _ DescrilWon Ql . Res.only Res.only
Tenant improvement or change of use: � —
ace.heated or conditioned?U Yes CJ No Air handling unit _CFM
Is existing
g s P Air on3�uonmg(site plan requ ) _
Is existing spare insulated?U Yes U No Alteration of existing nystcm
/ Boiler/compressors
Business pante: � � .. State(miler permit no.:
_ f/i i,L t << ,: �«,l; �C 11 _ HP Tons—_BTU/H
Address: „ Fire/smoke am r uct smoke detectors
BTUIH
City: r Stated !' ZIP�I.7? / Ileal pump site plan required)
Phone: -�7 511 Pax: '_ >�..: Email: nsta rep ace urnac umcr
--- Including ductwork vent liner— ULYes U No _—
CCB no.: /C'- c 3 -r-. 11rep ao re ocatc eatcrs-suspen ed,
City/metro lic.no.: A-,,c, C--' wall,or floor mounted
Name(please print): enc ora rant-a oFier than urnacc _
1 1 of gerat on:
Absorptionunits BTU/II
Name: Chillers r NP _
Address Com tressors-T _ III,
n rountenta ex tet an tent lation:
City: _-_ tate: ZIP: Appliance vent --
Phone Fax 1 neail hyerextoust
floods,Type U IUrcs. tc a azntat
hood fire suppression system
Name: Exhaust fan with single duct(bath fans)
Mallin address: V, . Exhaust system a art from heatingor
y _, y 1 t
'
Cit
i
Fuel piping distribution(up to 4 outlets)
Lhcl �_. NO Oil j
PIli mc 1 E-mail: Fuel pipin eat a diona over 4 out I et
11'roem. piping(sc ematic require— )
Name Number of outlets
ter 1WIed appliance or equipment.,
Address: __ Decorativef re lace
State: ZIP: nsert-type
Phone: I a,. Email « stov pe et stove
(Xere
Applicant's signature: Date: i t
Name(prinq: > {
Not VI laniK6cu�xa Ka(M credit tint!,pleau call luaialarrltm for nx+re InrarnWlwa. Permit fee.....................$ r cx
L1 Yaa U onshinWe l"yr Notice:This permit application Minimum fee................$
expires if a permit is not obtained Plan review(at �_ `sF) $
�1°dt'mrd number -- ---- , within 190 days after it has been c 4 C
State surcharge(8%) ....$
Rim CA rlde----`-u i ai—iwn on eTii Car— $ accepted as complete.
TOTAL .......................$ , h
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CadlicAder siRruiure --- — AnKmi 1404617(WWOM)