11060 SW 115TH AVENUE f
^.
,
.. .
1 CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 6394171
Date Requested: __ ^ �, `C f 7 A.M. M. MST:
Location: I C' I= �.L.� f/ .." -'t.�.'`�. r BUP:
Te:tant: _._ Suite: Bldg: MEC:
Contractor: 7— C 4 t L CA L L Phcme PLM: _
O1• t: Phone: 0 BLC: �—
SIT:
BUILDING BLDG(can't) MECHANICAL v ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Bcam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masoruy Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Ir Heat Pump Low Volt
Approved row Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL b:` FINAL FINAI FINAL
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F–
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W - -- ---_ --------
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D Call for r
einspection O Reinspection fee of S requifedbefore next inspection O Unable to inspect
/ -�l
Date: _ Pege�of
Inspector :"z _._
CITY OF T MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 57223 (503)639-4171 PERMIT #. . . . . . . : MEC97--O&,,51. i
DATE ISSUED: 12'/05'97
PARCEL.: 1 S i 34DP-01400
SITE ADDRESS_ : 1. 1000 SW 115TH AVE
SUBDIVISION. . . . : ZONING: R-4. 5
BLOCK. . . . . . . . . . . I.OT. . . . . . . . . . . . . . JURISDICTION: TIG
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
-1Y171E OF USE. . . . :SF UNIT HEViTERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R3 VENTED W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 POILERS/COMPRESSORS HOODS. . . . . . . : 0
F=UEL TYPE,—- ..----------- 0-3 HP. . . . : 0 DOMES. I NC I N: 0
:GAS 3-15 HP, . . . : 0 COMML.. I NC I N: 0
MAX INPUT: 0 BTt..) 15-1`10 HP. _ . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 30+ Hp'. . . . : 0 CLO DRYERS. . : 0
h1O. OF UNITS---__.______— AIR HANDLING (IN I TFT OTHER UNITS. : 0
1=-URN ( 100K BTU: 1 (= 1.00001 cf m . 0 GAS OUTLETS. : 1
F=URN ) =1O0K BTU: 0 > 10000 cfm : 0
R e m ar~I4 s : Install one furnace and gas piping.
Owner: ______..____...______.___.__._---_______.___ FEES
TOHN JACYNO type amour. tai, date recpt
11O60 SW 115TH AVE PRMT $ 25. 01to ^A 12/05/97 717-..301468
TIGARD OR '?7L23 SPCT $ 1. 2275 DRA 1.2/05/97 9T-3O14(;13
Phone #:
' Contractor: ---------------------------_. ._
FIRST CALL MCCALL HEATING &
COOLING -----------------------------------
1.650 NE LOMBARD f 2G. 25 TOTAL
PORTLAND OR 97211-4798
Phone #: `:51-3311
Reg #. . : 001020
— ----- RE')UIRED INSPECTIONS
This pewit is issued subject to the regulations ccntained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanic:a?. Insp
applicable laws. All work will be done in accordance with Final. Inspection
approved nlans. This prrvit will expire if work is not started
within ! ' days of issuan(:, or if work is suspenoed for sore
a than 180 days. ATTFNTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
Vi set forth in OAR 952-W-W10 through MR 952-N81-0080. You eay
> obtain copies of these rules or direct questions to llt1NC by calling
1503)246-9181. ._
UJ
Iscsue $y: II Permittee Signati_tre : ler ,
+-++++++.+++^4-++.ti•++..+i-. ...+++t-1-.....+-F+t+ -F+....1- ++4--}++1.+t+++-4.+-1.....4-+
Call 639-4175 by 7:00 p. m. for inspections needed the ne <t bl..isiness day
+i....++++-F++t.+t+i-++++++.+i--F4...+-F-f-Fi-++++++.t++++-Ft.ti..1-++-F++. .+++++++°F++.++i i
Plan CheckiR
CITY OF TIGA.RD Mechanical Permit Application Recd®y tib-
13125 SW.HALL BLVD. Commercial and Pesidential Date Recd
TIGARD, OR 97223 /?' I Date to P E.
(503) 639-4171, X304 r� Date to DST___
Print or Type ! "err"itx _=0 1
Called
Incomplete or ille-ible app;ications will not be accepted
Name of DevelopmenVProlect Description
Table 1A Mechanical CodeCITY PRICEAf fT
,lob sweet Address suileA A)� Permit Fee -0- i 1L 00
Address I \ (D �-' C_, -/-? ��.; \\,
i3kIgS City/State Zip 1.) Furnace to 100,000 BTU , 6.00
including ducts&vents I J
Name(or narne of bu4iness) 2.) Fum ice'00,000 BTU+ 750
Owner .� a V-\r _\ n C.) including duds&vents
wading Addres. - 3.j Floor Furnace 6.00
inrluCmg vent
iStare -` - yo Phone 4.) Suspanded heater wall heater 6.00
_ or floor mounted heater
R^ Name( name of burin aa) 5.) Vent not included in appliance permit
-� CSC �l ` _
Occupant ~+siting Addressn 6.) Boder or comp,heat purrs air Gond. 6.00
i L�'`' �-�-� to 3 HP:absorb unit to 100K BUT"
Cltyfstate p Phone 7.) Bader or comp,heat pump,air Gond. 11.00
Cti r- '-k 6 3-15 HP:absorh unit h 500K BTU"
CCntractor Name 8.) So(ler or comp,heat pump,air cond. 15.00
t 0,ei I 1 Cl. 15-30 HP:absorb und.5-1 and BTU"
Prior to permit Maiiing Address / 9.) Eoder or comp,heat pump,air Gond. 92.50
issuance,a copy i L %!/T1 f)�C i r 30.50 HP:absorb unit 1.1.75mil BTU-
of all licenses quY/State zi Phone Z \ 10.) Boder or comp,heat pump,air Gond. 37.50
are required if / C i,( J � 2- ( ( 3i 1 >50 HP:absorb unit 1.75 mil BTU"
expired in COT Oregon Const.Cont.Board!ia.tr Exp.Date 11.) Air handling unit to 10,000 CFM 4.50
database _ ( f7) 2 ('> � =j -� C(
Architect Naria 13.) Non-portable evrrorate cooler 4.50
or Matting Address 14.) Vent fan connected to a single dud 3.00 +
Enginber cityfsate zip Pho+e 15.) Ventilation system not included in 4.50
appliance permit
Describe work New O Addition Alteration O Repair O 16.) Hood served by mechanical exhaust 4.50
to be done Residential O Non-residential O _
Additional Description of work: c f 7.) Domestic incinerators 7.50
1 18.) Commercial or industrial type 30.00
(_l._ 1 I n G2 C Incinerator
Existing use of 19.) Repair units 4.50
building or property _
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer,etc. 4.50
building or pruperty
22.) Other units 4.50
ri T�pe of fuel-oil O natural gas O LPG 0 electric O 23.) Gas piping one to four outlets t 2.00
V) I hereby acknowledge that I have read this application,that the - 24.) More than 4-per outlets(each) .50
information given is carred,that I am the ov, or authorized agent of
r-- the owner,that plans submitted are in cor,pIlance with Oregon State QTY.SUBTOTAL
laws.
Signature of Owner/Agent Date 'SUBTOTALC-D --,�
L8 LO
w l 596 SURCHARGE /ra U
nct Parson Name Phonacp: F PLAN REVIEW 25%OF SUBTOTAL
&/ 7V TOTAL �a
1:lrnechpmt.doa (rev 9 Minimum pem,it fee is S25+50.6 s rcharge
"Residential A/C neo hires site plan showing placement of unit.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone- 639,4171
I�
Date Requested: ( � ' _ A.M..x dlL`�' M _ MST:
Location: o G 1 ! _ BUP:
.enant _ Suite: bidg: � NEC:
�,yam ��_ Phone:
Contractor: ..c.i ii�vAC� __ PLM:_
O mer: r -1 - - C Phone. �' `�_ � ELC:
R:
T -- SIT:
BUILD BLDG(con't) PLUNIBING MRI VICAL ELECTRICAL SITE
5i.e Postlbeam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFUSlab Rough-In Ceiling Wa[er Line
Slab Framing Top Out Ott PP ,as Rouph-In UG Sprinkler
Foundation Insulation Sewer /'� uct Reconnect Vault
I3smt Damp
Drywall Storm— 'I Tc,mp Service ir".Sc.
Masonry Ceiling Rain UG Slab
Shear/Sheath Fire Spklr/Alyn Crawl/Found Dr I Leat Ptunp I T,W Volt
Approved Approved Approved Approved
Appr/Sdwlk Not Approved `iet Approved Not Approved Not Approved Not Approved
FINAL FQ�-L FINAL FINAL FINAL
r�.T: -:Vs-,— _ i%'S,t 6�,c- /s' l �.r✓�r>:✓S --
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rid
rl Call for reinspection D Reinspection fee of S required before next inspection (7 Unable to ftLVect
Inspector: i Date:�— �`r/ Page of
CITE( OF TIGARD PLUMBING PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : PLM97--0521
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 12/08/97
PARCEL: IS134DB-01400
SITE ADDRE59— : 11060 SW 115TH AVE ZONING:
SUBDIVISION. . . . : JURISDICTION: TIG
BLOCK. . . - . . . . . . : LOT. . . . . . . . . . . .
---------------------------------------------------------------------------- ----
CLASS OF WORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . .SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . i 0
OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRA.-"S. . . . . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 WATER 4EATERS. . . . . CATCH BASINS. . . . . . . : 0
FIXTURES-------------- L.f,I.INDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . — 0
( SINKS. . . . . . . . . : 0 URINALS. . . . . . . . . . . : 0 GREASE TRAPS. . . . . . . : 0
LAVATORIES. . . . : 0 oTHF',,i FIXTURES. . . . : 0
TUB/SHOWERS. . . : 0 SFWER LINE (ft ) . . . : 0
WATER CLOSETS. : 0 ;jATER LINE (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . : 0
Remarksi Install 50ga1 w/h
Owner: ------------------------------------------------------ FEES ---------------
JOHN JACYNO type amount by date recpt
11060 SW 115TH AVE PRKIT $ 25. 00 JSD 12/08/9"t 97-301494
'TIGARD OR 97223 5PCT $ 1. 25 JSD 12/08/97 97-301494
Phone #: 590-466P
Contractor-----------------------------------
FIRST CALL MCCALL
HEATING & COOLING
1650 NE LOMBARD
PORTLAND OR 97211-4798
Phone #: 231-3a11 $ 26. 25 TOTAL.
!?eq #. . : 010203 ------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal Code, State ref Ore. Specialty Codes :.nd 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. F,TTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-101-0010 through OAR 952-000I-0080. YOU may
obtain copies of these rules or Airect questions to OLIC by calling
(583)246-1987.
Tssued By:L ............... Permittee Signature:- zf��z
+f-++- .....r......... ............. ....................... ........i.............
Call 639-4175 by 7:00 p. m. for an inspection neecied the next business day
.......................................f.............................I.........
i
12/05/97 FRI 09:24 FAX 503 598 1960 CITY OF TIGARD _ ?002
CITY OF TIGARD Plumbing Appficadon Recd By
13125.SW HALL,BLVD. Commercial and Residential Date Read
Date to P.E.
TIGARD, OR 97223 Data to
(503) 6394171 Permit 1 �� - v7
Print or Type Relaters SWR sr
Incomplete or illegible applications will not be accepted Called_
Name of Dervelopment/Projer2 On back indicate Work Performed by rudum
i ,lobi c�sc�` �EIX�J��++`� lrndrvrd4 . " `- M F" 'r�11�
u Sink 9.00
Address street Ad� �j l.v ► , Lavatory — 9.00
Bldg f citymme ZIP Tub or Tub/Shower Comb. 9.00
Shower Only
900
, 9.00
�
1 Woter Closet alts�
owner MaiilingAddroaa Suite Dishwasher 9,70
-- r
Umbage L�sposal 9.00
tylstate 23p Phone Washln0 Machine 9.00
Name Fltxd Drain 2' .00
3` 9.00
Occta4ant Mailirx!iWdress Suite 4` — 9.00
_ ----- Water Hamer �ffversion O like kine! 9.00
ClrylSinte Zip h+hone
Laundry Room ray 0.00 _
--- ---- Name Urinal -------- -- 9.00
other Finlum(Specft) 9.00
Contractor MagingAddrasa zjta 0.00
Prior In permitZo!,
te zipPhone -- -
issuance,aCOPY (cAni
licenses < <IZ2� 1 Z31 33tr• 5.00
( of all are const.Cont.Board Liel Exp.Date 9.oa
required if l C .et s Sower-161100' 30.00
expired in COT Plumbing U&# EV-Date Sewer-each addrdor al 100' 25.00
1
database N Z `i- -`'I9
— -- Water Service-1st 100' 30.
Name
Water Service-each additional 200' 25.00
Architect , Storm 8 Raln Drain-1st 100 30.00
or Mailing Address Suite —
5'tomt A Rain Drain-eacn atltldionai lou' 25.U0
Engineer (itylState ZIP --- Phone Mobile Home Space 26•00
Commerdal gaci-Flow Piavand-on Device or 25.00
D.rscrlbe work New O Addition O Afleration O Repair O Pollution Device _
to be done' Residential 0 Non-residential O R-sidential Backflow Prevention • 1500
Addhlanal desrxi Ul"of work. Any Trap or Waste Not Connected to a Fixture 9.00
WY 0 :latch Basin 9.00 -
Inap.ofof Existing Plumbing 40.00
par/hr
[Y sling use n1 a y Raquostpd Inspections - 40.pm-0
bull, ny or property -
Ra simple amlly dwoNinp 30.00
Pruposed use of Grease Traps _ _ 9•W
p- bulldlnp or p,operty
- - _ QUANTITY TOTAL
N I hereby scknovrktdge that I have road this appllxAtlan,th/t the Informstion Isnmebtr.rx n+er diagram in required g Ouandr Total b 19
given is correct,that 12111 the owner or aulhadzed agent of the owner,and _ "SURTOTAL
> that plans submitted ere In compliance with Orman State Laws.
Sign of OwndmHA90ttt ban - j%8URGHARGE
J - i.nr H -\', r r-,•SLI__
PLAN REVIEW 25%of SUBTOTAL
cc -
t Parson N o is Ph" R ulred ar If ronure total I!y 9
e 4_ y Minimurn permR M Is S25+5%surcharge,except Residential BaWow
Prevention Device,which Is$15+5%surcharge
t11Y1r lift V dae SW