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CITY OF TIGARD MECHPNIVIL
DEVELOPMENT SERVICES PERMIT
PERMIT #, . . . . . . : ME097-0046
13125 SW Hall Bled., Tigard,OR 97223 (503)639-4171
DATE ISSUED: 0-2/28/97
r,ARCEL: 251.03AD-055:20
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TE %1DDRESS. . . 127[;0 SW 111TH PI_
IBDIVISION. . „ . : W1L.DF PN!=5S ZONING: P--4.. 5
OCK. .1 . . . . . . w . . LOT. . . . .
_.ASS OF' WORK. . :ALT FL..00R F"URN. . . . : 0 EVAP C:001-ERS: 0
,T-*,E OF USE. . . . .SF UNIT HEATERS. . : 0 VENT FANS. . . ; 0
_:CCUPANCY GRP. . :Rw, VENTS W/O APPL.: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOII._ERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPE.a_---....__..._._.......__. .. 0-3 HP. . . . : 0 DOMES. 1I`'i Ihlc V1
: /GAS/ 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX TNPUT: 0 DT111 1.5 _320 Hr'. RF iTR UNITS. 0
FIRE DAMPERS'. . : 30._.50 HP. . . . : 0 WOODSTOVES. . ,: 0
ETAS PRESSURE., . . : 50+ HP. . „ . . 0 C.I_O DRYF_RS. . : 0
NO. OF UNITS---- - ---- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 1.00K BTU: 0 <- tool;!1 r.!`m : 0 [3AS OUTL._ETS. : I
FURN ) =100K BTU: 0 > 10000 cfm : 0
Remarks : Tristallation of ga-, piping from meter, to I-iol.rse.
Owner-. —.___.____.__..___ _____._._________.._._._ _.__________----__. ______—_- FEES
Dfl!rII) NE:LSC)N type amol.rnt by cla.te recpt
12760 SIA 1 i. 1TH PRMT $ 25. 00 DRA 02/2a/97 97-•291069
SPOT $ 1.,, ..'S DRA, 0 :/28/97 '97-291.069
TTGARD OR 97223
Phone #t:
Contractov-:
OWNER
Phone ff• $ 26. 25 TOTAL_
Reg W. . : 131.25
- - - _ - REQUIRED INSPECTIONS
— -- _--
T`is permit is issued subject to the regulations rontained in the Gas L.i.ne Insp M
3ard Municipa'. Code, State of Ore. Specialty Codes and all other Me,chanir_al. Tnsp
rlica�le laws. All work will be done in accordance with Final Inspection
approvee plans. This persit will expire i` work is not started _
thin V days of issuance, or if work ;s suspended for sere
an 188 days.
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Call for inspection - 639-4175
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing I9ain DrF.in Cover/Service FINAL:
Foundation Water Line Ceiling lumb.
Post/Beam Mach. Shear/Sheath Framing ecli.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation ..Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bidg.
San. Sewer Ga^ Line Appr/Sdwlk Reins.
Other.
Date: _ r1 `1 - - A.M. �P.M. Entry:
Address: ( -7 Q / I I — —
Tenant: Ste:_ MST: _
Con/ n �C'�������.+�0�-- MEC:
C PLM:
THE FOLLOWING CORRECTIONS A�E REQUIRED: EL.R: _
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InZPPROVED'
ctor:
_v Date: ��
—DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FIN
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framing -Meeh.
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. ec . Rough-in Gyp. Bd. -Bldg.
San. Sewer as Line Appr/Sdwik Reins
Other:
Date: 3 A.M. —P.M. Entry:
Address:
Tenant: Ste: MST:
xP.
.39- y'k 9 - ME
w MEC:
PLM:
L C ELC: _
THE FOL OLLOWI OWI FIRE TlN4 ARE REQUIRED: ELR:
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Inspector Date: .31 �
''APPROVED _DISAPFROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTIC
Inspection Line: 639-4175 Business Phone: 53941 1
Footing Rain Drain Cover/Service KI AL:
Founrla+.on Water Line Cen;no dumb.
Post/Beam Mech. Shear/Sheath Framing -Mach.
Plbg.Und/Flr/Slab Plbg Top Out Insulation -Elect.
Post/Beam Struct, Mach. Rough-in Gyp. Bd. -Bldg.
San. Sewer Appr/Sdwlk Reins.
Other: � r
Date: A.M./ M. Entry:
Address: sz� �_ _ _L1 9-4,�
Tenant: — Ste: MST:
BLIP. —'
Con/Own: __- _- _ MEC:� c
PLM: _
ELC: —
THE FOLLOW114G CORRECTIONS ARE REQUIRED: ELR:
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Inspector:
RPAr' DISAPPROVED/CALL FOR REINSP, OF dO
r,�rmit #: U 7 7-C 0V6
Adc.ress: a�
Issued by ��. 31 t, Date: =. -
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registerku with the Construction Contractors Board to sign the
following statement before a Suilding permit-.in:be issued. This statement is required
for residential building, electrical, mechanist and plumbing permits. Licensed
architect and engineer applicants, exempt from registration tinder ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2, acid either box 3A or 3B:
[TE 1. 1 own, reside in, or will reside in the completes' structure.
- 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
❑ 3A. My general contractor is --
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure inust be
registered with the Construction Contractors Board.
OR
-J 3B. I will be my own general contractor.
If 1 hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If i change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
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I hereby certify that the above information is correct and Ili-it I have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
Ja6'iaz 2,-;- C
(Signature of permit applicant) (Date
(White copy to issuing agency permit file,
pink copy to applicant)