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[C Lol } J G� > Cm7 c -� Gj O N cF O C 0 co O € ij N W « c N N a) a Nm J C d c � V) m c c U y « N Na ma O O U V) LE U NN o 0 o rn N o 0 � Q Q a cl F, Q- a a a a CITY OF TIGARD BUILDING INSPECTION DIVISION Ms ���� J0,P 7 J 24-;our Inspection Line: 639-4175 Business Line: 639-4171 � BUP Date Requested AM PM _ BLD _ Location '-10 Suite M Contact Person _ Ph 577 - 7S-`!S-� Ler�-- Contractor Ph SWR ILpJI Tenant/Owner ELC Retaining Wall ELR Footing Access. Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab Post&Beam ` Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drvwall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof ^~' M isc: ----. -- n S PART FAIL -------- /" MBI _ Post& Beam u — Under Slab _ Top Out —' Wale e eta Sewe. a rn AS PART FAIL Post& Beam -- -- - --- ---- Rough In Gas LineSmoke Dampers Dampers A PART FAIL ELECTRICAL -- - - ------- ---- Service _ Rough In — a UG/Slab CIL: Low Voltage v~ Fire Alarm > Final _.— �' PASS DART FAIT_ SITE Backfill/Grading - ,� Sanitary Sewer -� Storm Drain I )Reinspection fee of$ _ required before next ii,apection. Pay at City Holl, 13125 bW Ha1l Blvd Catch Basin [ )Please call for reinspection RE _ [ ;Unable to inspect-no access Fire Supply Line ADA /� --� Approach/Sidewalk Date Inspectory--A\ "`"-"'�` Ext , Other �— -- Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. rITY OF TIGARD BUILDING INSPECTION _ VISION �M �1 �G��,dG 2,7_3 24-vi Inspection Line: 639-4175 Business Line- 639-4171 — ' i e1UP Date Requested q100 AM PM /,60q, w L, — Location 12- C) q Q V r Suite MEC Contact Person C-)re's Ph PLM 1 qq I `Qn Z Contractor_ Ph SWR Tenant/Owner ELC Retaining Wall EI_R Footing Access: Fo.indation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab ( , �� SIT -- Post& Beam T Ext Sheath/Shear Int Sheath/Shear Framing Insulation `- Drywall Nailing` Firewall - Fire Sprinkler r --� `��� �`✓1 5 W�� Fire Alarm ri Susp'd Ceiling Roof misc PART FAIL Post& Beam ^ (Under Slab Top Out V�aler-Service _ incl -�— � PART FAIL (gECHAN&AL �•� �r�_ ✓art_ __ _v�-� C�� f_ Post& Beam -- Rough In Gas Line -----� - _ � �_4 _ -i/1_..- Smoke Dampers LAJ aC in --- -- — :%_ __—-- ASS FART FAIL 1 r . C1 RICAL `�� — Service _ Rough In UG/Slab NLow Voltage — Fire Alarm _ T_ Final PASS PART FAIL. '1rZ1�J"-'t 4 _ J �` - SITE Backfill/Grading LijJ Sanitary Sewer 3• '� w - �� _ Storm Drain [ Reinspection fee of$ required before next inspection. Pay at City hall, 13125 SW Mall Blvd Catch Basin [ J Please call for reinspection RE: _ [ J Unable to inspect-no access Fire Supply Line ADA Approach/Sidewalk Date C\ Inspector _ � _ Ext 1 Other -- --- Final PASS PART FAIL 00 NOT RErOOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST ,`�tq_ Z0-�X-7 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 1 BUP _-- Date Requested_ �1�/� / AM PM BLD Location— 11� 0`-f 6 AV-e— _y Suite MEC Contact Person (r/f Ph "� � PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl main Inspection Notes: SUN Slab 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 PART FAIL PLUMBING Post&Beam - - Under Slab Top Out Water Service Sanitary Sewer V -- R-",Drains Final PASS PA RT FAIL MECHANICAL Post&Beam ----- _- -----.�--- — — Rough In Gas Line ---- ----- - -- - — -- Smoke Dampers Final -- -- --- _ — PASS---PARI,_ FAIL ELECTRICAL - -— - Service Rough In _ UG/Slab Low Vnitage V1 Fire Alarm PASS PART FAIL J Backfill/Grading - -�-- -- w Sanitary Sewer J Storm Drain ( j Reinspection fee of$V _required before next inspection. Pay at City Hall, 3125 SW Hall Blvd Catch Basin i Please call for reinspection RE:_ f I Unable to inspect-no arrpc. Fire Supply Line ADA Approach/Sidewalk C� Other Date/;--/7— ! �Inspector Ext Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD PLUMBING PERMIT i DEVELOPMENT SERVICES ORIGIN PERMIT#: PLM1999 00282 13125 SW Hall Blvd.,Tigard, O►. 97223 (503) 639-4171 DA ISSUED: 09/10/1999 SITE ADDRESS: 12040 :>W 116TH AVE PARCEL: 2S103BA-00125 SUBDIVISION: LERON HEIGHTS NO. 2 ZONING: R-4.5 BLOCK: LOT: 039 JURISDICTION: TIG CLASS OF WORK: OTR GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES _ LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER L.NE: 100 ft WATER CLOSETS: WATER LINE: 300 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Add sewer line and water line for the new accessory structure Owner: FEES _ 116T NSON Type By Date Amount Receipt TERRY HUPRMT GEO 09/10/199r $108.00 99-318238 12040 SW 116TH 5PCT GEO 09/10/199 $7.56 99-313238 TIGARD, Crl 97223 Total $116.56 Phone 1: 503-521-1232 Contractor: WARNKE PLUMBING 6306 GLEN ECHO AVE GLADSTONE, OR 97027 REQUIRED INSPECTIONS Phone 1: 656-6265 Sewer Inspection Reg #: LIC 0005264' Water Line Insp PLINI 26-331 F Final Inspection a This permit is issued subject to the regi !:tijc�nft ::ontained in the Tigard Municipal Code, State of OR. JSpecialty Codes and all other applicable laws. All work will be done in accordance with approved plans. t This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more w then 180 days. ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0j)Oj 0080. YOU may obtaicopies of these rules or d' ect questions to OUNC by callin,$)(50 246- Issued By: Permittee Signature: ;; Call (503) 639-4175 by 7:00 P.M. for an Inspection needed the next business day CITY OF TIGARD Plumbing Permit Application Plan Check# 13125 SW HALL mi.-VD. Commercial and Residential Recd By TIGARD, OR 97223 Date Recd (503) 639-4171 Date to P.E. Print or Type Date to DST Incomplete or illegible applications will not be accepted Permit#�c-r� Related SWR# Called Name of DevelopmenUProject FIXTURES (individual) QTY PRICE AMT Job Sink 11.50 Address Street Address f Suite Lavatory 11.50 Tub or Tub/Shower Comb, 11.50 Bldg 11 City/State Zip Shower Only 11.50 Name — Water Closet/Urinal (Specify) 11.50 I `•'f'/ ���rGH/!�/�� Ul;,nwasher 11.50 Owner Mailing Address Suite Garbage Disposal 11.50 j,' / ^Y __ Washing Machine/Laundry Tray (Specify) 11.50 City/State Zip Phone Floor Drain/Floor Sink 2" 11.50 Name 3" 11.50 .rr/4-y�1 4" 11.50 Occupant Mailing Address ^cite Water Heater O conversion O like kind 11.50 Gas piping requires a separate mechanical permit. City/State ZIP Phone MFG Home New Water Service 28.00 MFG Home New San/Storm 1 awur 18.00 Name N N if rr Hose Bibs Contractor Mailing Address Suite Rain Drains 11.50 Drinking Fountain 11.50 Prior to permit City/State Zip Phone Other Fixtures(Specify) 1500 issuance,a copy of all licenses are Oregon Const.Cont.Board Lic# Exp,Dale required if 11)G G,11 r. expired in CO r Plumbing Lie.# E .Date database /� ', J/ 0 Name Sewer-1st 100' 38.00 Architect A-110 r 11 Sewer-each additional 100' 32 00 or Mailing Aa,�ress Suite Water Service-1st 100' f 38.00 Engineer City/Stale ZIP Phone Water Service-each additional 200' i 32 00 Storm 8 Rain Drain-1st 100' 38.00 Descrite work to F;done: Storm&Rain L sin-each additional 100' 32.00 New C Repr.lr O Replace with like kind Yes C No O Commercial Back Flow Preventicn Device 32,00 Residen'ial 'O Commercial O _ Residential Backflow Prevention Device' 19.00 Additional description of work: I hatch Basin 11.50 Insp.o!Existing Plumbing 50.00 Are you capping,moving or replacing any fixtures? perthr Yes O No O Gnecially Requested Inspections 5000 If yes, see back of form to indicate work performed by _ __ error C1 fixture. FAILUR''10 ACCURATELY REPORT FIXTURE Rain Drain,single family dwelling— 45.00 WORK COULD RESULT IN INCREASED SEWER FEES. Grease Traps 11 50 t-- _ V) I hereby acknowledge that I have read this applicrlion,that the information QUANTITY TOTAL y given is correct,that I am the owner or authorized agent of the owner,and Isometric or riser diagram Is required if Quan'q total is >9 t-- that plans submill-ad are in adlnpliance with Oregon Slate Laws. •St}BTOTAL Signaturn of Owner/Agent D It L _ �" 7% SURCHARGE Conte t Person Name hon J i��,E'l�. /�N',f9e/2-ti" `t 75 $ "PLAN REVIEW 25% OF SUBTOTAL 1 BATH HOUSE$178.00 Required only If f ire qty total is>9 2 BATH HOUSE$250.00 TOTAL 3 BATH HOUSE$285.00 (This fee Includes all plumbing fixtures In the dwelling and the first 100 feet of sanitary sewer storm sewer end water service) 'Mime m pnrmlt tea Is S50 7%surcharge,except Residential Backflow Freventbn Device,which is$25+7%surcharge "All New r�ommarrlsl Buildings require plans with Isometric or riser diagram and plan review I wdslsltorrnslplumapp doc 7/19199 II , - i PLEASE COMPLETE_ — i Fixture Type —_ Quantity by Work Performed New (Moved Replaced Removed/Capped Sink __ — — --- Lavatory — Tub or Tub/Shower Combination _ — Sh ver Only — — Water Closet _ — Dishwasher Garbage Disposal --- — Washing Machine — _ - Floor Drain/Floor Sink 2" 3„ -- 4„ Water Heater — - Laundry Room Tray — Urinal __ --- -- -- Other Fixtures (Specify) -- COMMENTS REGI RUING ABOVE: J _ — F1dgU110nntbhxn6W dot 7119199 ' �►RD MASTER PERMIT CITY OF TIG PERMIT M MST1999-00273 DEVELOPMENT SERVICESJG I NA TATE ISSUED: 09/07/1999 -� 13125 SW Hall Blvd.,Tigard, OR 97223 (503) -4 SITE ADDRESS: 12040 SW 116TH AVE PARCEL: 23103BA-00125 SUBDIVISION: LERON HEIGHTS NO. 2 LuNING: R-4.5 BLOCK: LOT: 039 JURISDICTFON: TIG REMARKS: Finish existing structure. BUILDII REISSUE: STORIES: 1 FLOOR AREAS REG UIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: 12 FIRST: of BASEMENT: .J LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: of GARAGE: 476 of FRONT: PARKING SPACES: 1 YPE OF CONST: 5N DWELLING UNITS: 'INBSMENT: of RIGH1. VALUE: S 6,091.66 OCCUF ANCY GRP: R3 BDRM: BATH: TOTAL: of REAR: PLUMBING _ _ SINKS: WATER CLOSETS: I WASHING MACH: LAUNDRY TRAYS. RAIN DRAIN: 0 TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUSISHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: GTHER FIXTURES: MECHANICAL- _ FUEL TYPES FURN<100K: BOIUCN"<3HP: VENT FANS: i CLOTHES DRYER: FURN>=100K: UNIT HEATERS: 1 HOODS: OTHER UNITS: 2 MAX INP: blu FLOOR FURNANCES: VENTS: WOODSTOVE.c: GAS OUTLETS: 1 ELECTRICAL. _RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 100 amp: 1 0 200 amp: WISVC OR FDR: 1 PUMPIIRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 400 amp: 201 400 amp: 1st WIO SVC/FDR: 0 SIGN/OUT LIN LT: PER HOUR: LIMITED ENERGY: 4n1 600 amp: 401 600 amp: EA ADDL OR CIR: SIGNAUPANEL: IN PLANT: MANU HM/SVCIFDR: 601 - 1000 amp: 601+ampo•1000v: 41NOR LABEL: 1000+amp/volt PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS: SVCIFOR>=225 A.: >800 V NOMINAL: CLS AREAISPC GCC. ELECTRICAL•RESTRICTED ENERGY A.SF RESIDENTIAL _ _ B.COMMERCIAL AUDIO R STEREO: VACUUM SYSTEM: AUDIO&STEREO: FIRE ALA`' INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM, OTH: 1301LER: HV- LANDSCAPEIIRRiG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 0 SYSTEMS: Owner: Contractor: TOTAL FEES: $ 559.96 This permit is subject to the regulations contained in the GREGORY L ANDERSON Tigard Municipal Code,State of OR. Specialty Codes and CONSTRUCTION all other applicable laws All work will be done in PO BOX 681 accordance with approved plans. This permit will expire If CANBY,OR 97013 work is not started within 180 days of issuance,or if the work is suspended`or more than 180 days. ATTENTION. Phone, Phone: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those rules are set Reg 0: LIC 26159 forth in OAR 952-001-0010 through 952-001-0080. You N may obtain copies of these rules or direct questions to r OUNC by calling(503)246-1967. I— REQUIRED INSPECTIONS I Sewer Inspection Plumb Top Out Water Line Insp Footing Insp Electrical Service Electrical Final Lit Slab Insp Electrical Rough In Mechanical Final J Plnt/undslab Insp Framing Insp Plumb Final Mechanical Insp Rain drain Insj Final Inspection Issued By Permittee Signature Call (50 ) 639-4175 by 7:0 p.m.for an inspection needed the next bu Hess day CITY OF TIGARu Residential Building Permit Application Plan Check t3126 SW HALL BLVD. Alteration - Interior Only Recd By �1 TIGARD,bR 97223 Single Family Detached or Attached (Duplex) Date Recd V 503-539-4171 Date to P.E. i Date to DST W-1Q -f y kr F 503-684-7297 Permit#Af F-1 -&jx33 Print or Type Called - Incomplete or illegible applications will not be accepted Ff=39 51 w �kEcP ez Name of Proje R0,< ti Name Job Address Site Address Architect Mailing Address N�r eO O Sw l i City/State. Zip LPhone EOR U7C041 A/S vr'/ Name Owner Mailing Address /2 QL40 PhEngineer iAaiRng Address City/State Zip one g /, ,l Z Mame General Z City/State Zip Phone Contractor led. QS„iV �,,y,� Describe work New O Addition O Alteration Repair O Mailing Address to be done: Prior to permit u R,)x - f Additional Description of Work: issuance,a copy City/State Zip Phone �N 5 �� rSr7lvt. 6-rn�K T-V 2�w of all licenses CANB' d X13 S M-4'55•S are required if Oregon Const.Cont. Board Exp.Date 'PROJECT expired in COT Lic.# database ,Zt..l 5 9 VALUATION �/ 2� [�ca Met<.hanical name 7 NEW CONSTRUCTION ONLY: _ Sub- Sq: 4- 4m9e: Sq. Ft. Garage Contractor Mailing Address ' 6, Prior to permit Indicate the restricted energy installation by the electrical issuance,a copy City/State Zip Phone subcontractor in the follow' g areas of all licenses Restricted Audio/Stereo are required if Oregon Const. Cont. Board Exp.Date Energy System Alarms expired in COT Lic# Installations Vacuum Irrigation database System S stem Plumbing Name (check all that Other: Sub- j-)&%, W,10nit6 Pty, apply) Contractor Mailing Address Corner Lot YES NO Flag Lot YES NO ___(check one (check one Prior to permit City/State--y—p— Phone Has the Subdivision Plat recorded? N/A YES NO issuance,a copy (,1p3rVNe- v,e L,5(y- Solar Compliance of all licenses are Oregon Const.Cont. Board Exp.Det required if Lic.# I Calculation Attached expired in COT -) 7;_ t �L I hearby acknowledge that I have read this application,that the database Plumbing Lica# EXp. to information iven is correct,that I am the owner or authorized agent ? J l '�/ of the own , an hat p submitted are in compliance with ?�f ^� � ) Oregon S t la _ Name Signatuif of O er/ ��-Dale Electrical LI-INLLe t-f ("�nlsr72✓r rr�� $ S 9`� Contact P rson Name ,~ Sub- Mailing Address _ Pone# Contractor 1 � ;,may GP (-0r OC 2Sc� ld-LZ—s5s5 FOR OFFICE USE ONLY: City/State Zip Phone Prior to permit Plat 0: / � MaplT�#: s3sy -� issuance. a copy }i/OXYa20 0 l< r v _ Z y� of all licenses are Oregon Const Cont.Board f:xp. Date Set4ackG �' Zone: S LU required if Lic# / ��J)�� I _ / -' expired in COT Ut` ? �� Engine ring Appro a: PI nning Appr val: TIF. database Electrical Lic # _F.xp. Date 4$_(v*to Elec.rical Supervisor Lic.# Exp. Date i formsWintalt.dOL(DST)10/23/98 CITY OF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT 13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PERMIT ff. . . . . . . : MFC98-0227,1 DATE ISSUED: 06/12/98 Fri'iRCEL: E'S I03BA-00125 S TTE ADDRESS. . . : 12040 SW 1, 1,ETH AVE SUBDIVISION....: LERON HEIGHTS NO. 21 ZONING: R--4. -' BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :039 JURTSDICTION: TIC-; CLASS -------------------------------- ----- CLASS OF WORK. . :ALT FLOOR TURN. . . . : 0 EVAM CO(1L_ER,13: 0 TYPE OF I-ISE. . . . :SF UNIT HEATERS. . it VENT FqNS. . . : 0 OCCUPANCY GR)-'. . :R3 VENTS W/o APPL. 0 VENT SYSTEMS: 0 STORTES. . . . . . . . : 0 B011 ERS/COMPRESSORS HOODS. . . . . . . .. 0 FUEL. TYPES­---­------ 0­3 HP. . .. . - tt, DOMES. TNCIN: 0 3-15 HP. . . . - 0 COMML.. INCIN: 0 MA X T NP U T 0 13 T Lf 157--,-30 HP. _ . : 0 REPAIR UNITS- 0 ETRE DAMPERS". . . 310-50 HP. . . 0 WOOD STOVES. . - 0 GAS PRESSURE. . 710+ )LIP. . 0 CLO DRYI:712S. . . 0 NO. OF UNITS------ ATR HANDL. 11\15 LIN T TS OTFIFR L)NITS. : I F"URN ( 10011, OTU: 0 10,7100 Cf111 : 0 (-7AS) nuTLETS. . 1, PORN ) =100V STU- 0 > 1.0000 :fm : 0 Rent.-ii-k,3 : Gas insert and piping Owner.- STEVE JONES type amount by date recpt 1'2,040 SW 116TH AVE: PRMT $ C-1.5. 00 B 06/12/98 98--30648,'t TTGnRD OR 972,1213 5PCT t 1.. 25 D V; 1,2/9 n 9(1 70(-,ei!I/i nic)ne #.* 190-5677 Contr-arta-,,: HOT SPOT FTREPLACE 8, PAT TO 11525 SW CANYON RD --------- ti 26. 25 TOTAI. BEAVERTON (111 97005 Ptini)e fl : 503-626-4(=552. Reg #. . : 00071.7 REUL)IRED IIS'-PFCTIONS' This permit is issued subject to the regulations contained in the (:-,as Line Insp Tigard Municipal Code, State of Ore. Specialty Codes an' all other Misc. Inspection applicable laws. All work will be done in accordance with Final Inspertion approved plans. This permit will Pxpi,-p if work is not started within 10 days of issuance, or if work is suspended for, more than IN rays. ATTENTION: Oregon law requires yon to follow rules adopted by the Oregap Utility Notification Center. those rules are set north in OAR 952-001-0010 through OAR 952-0014080. You Pay obtain copies of these rules or direct questions to OtNC by calling (503)246-91871. J 4........4-+-1-++++-+++ F-++4-+++++++++4.............4+++++1-++++++•I-+.++++•.+++ .1-.....4-+++ Call 639--4175 by 7:00 p. m. fat- i.ispertj ons i. -ed(rd the next bl,lsirless day 4.................f....... ++4+++++++++++++++++++... ...............t...4-++4 Plan Che � A CITY OF TIGARD Mechanical Permit Application Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd l� (?11 TIGARD, OR 97223 Date to P.E. (503) 6394171, X304 Date to DST Print or Type Permit Called Incomplete or illegible applications will not be accepted Name Of Dev"pmentlProdert Description Table 1A Mechanical Code OTr PRICE AMT Job Street Address Swan A) Permit Fee -0- -0- 10.00 Address 1A D YO sa) l ewgr City/State ZJp 1.) Furnace to 100,000 BTU 6.00 66e a� including ducts&vents Name(or narne of business) 2.) Furnace 100,000 BTU+ 7.50 Owner c- p including duds 8 .ants Marr*Address 3.) Floor Furnace 6.00 including vent cltylsale Zip Phone 4.) Suspended heater,wall heater 6.00 or floor mounted heater NUN dr none of busnus) 5.) Vent not included in appliance permit :1.00 o tl"7 4 _ 0awant ~tarn*Address 6.) Bolter or comp,heat pump,air cond. 6.00 to 3 HP;absorb unit'o 100K BUT" cityrstate zip Prton• 7.) Boiler or comp,heat pump,air Gond. 11.00 590.557 3-15 HP;absnrh wait to 500K BTU" Contractor Norm K07T SA267' 8.) Boiler ri comp,heat pump,air Gond. 15.00 (Prior to rfl<MECHWICA-LI t;-30 HP;absorb una.5-1 mil BTU" Issuance Mailing Address9.; Boiler or comp,heat pump,air Gond. 22.50 applicant c�As.�I4 d 30.50 HP;absorb unit 1.1.75mil BTU" must provide ail rstaa zip Phone 10.) Boiler or comp,heat pump,air Gond. 37.50 contractor >50 HP;absorb unit 1.75 mil BTU" IICerm Oregon Const.Cont l3bard LicaE h.Dae 11.) Air handling unit to 10,000 CFM 4.50 Information �5 4 7 for COT COT Busttns Tau or Metro n G .Date 12.) Air handling unit 10,000 CFM 7.50 database). Architect Name 13.) Non-portable evaporate cooler 4.50 or Mailing Address 14.) Vent fan connected to a single duct 3.00 EngineerCryrSate ZIP Phone 15.) Ventilai;on system not included in 4.50 appliance permit Desalbe work New O Addition O Afteration Repair O 16.) Hood served by mechanical exhaust 4.50 to be done Residentlal O Non-residential O _ Additional Desetlptbn of work 17.) Domestic incinerators 7.50 18.) Commercial or industrial type 30.00 Incinerator ExtswV use of 19.) Repair units 4.50 building or property �5 i a ElJ 71-121c. 20.) Wood stove 4.50 Proposed use of 21.) Clothes dryer,etc. 4.50 n building or property 22.) Other units v fiS �Ns�k-.r 4.50 � `j > Type of fuel-oil O natural gas LPG O electric O 23.) Gas piping one to four outlets 2.00 p6 -� I hereby acknowledge that I have read this application,that the 24.) More than 4-per outlets(each) .50 r infornabon gNen is correct,that I am the owner or authorized agent of the owner,that plans submitted are in compliance with Oregon State OTY OTAL w laws Signature of OwnerfAgent Date SUBTOTAL / Vii( --�-- 5%SURCHARGE f(J PhontG a CJ PLAN REVIEN 25%OF SUBTOTAL C tact Person Name / ��•^ Sr�vE �d L'S 10.7 C7tCX] TOTAL rp �i 1:1dsiVnechpmLdoc (rev 9 ---Minimum permit fM is$25 . .i%surcharge "Re3 iimtiat Alf reTuires site plan showing placement of unit. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line:6394175 Business Phone: 6394171 Date Requested: J�",W/1 12 1 ` l A.M. P�M.T MST: Location: 2 C- 0 S-CA-), 11TH BUR Tenant: n — Tenant: Suite: Bldg: MFC: 2 7" C 7C, Contractor:—A E1,,L C H t C 5 71 - 2- Z T� Phone: PLM: Owner:_ `til V E BA K-L'k" — Phone: Y I 0 N N F g A-K F 9 -' ELC: PLEA E 1';C?E A <., 13AKWELR: I<-, V u ' L r1 o M F SIT: BUILDING BLDG(con'() PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Bcam Post/Beam Cover/Service Sewer/Storm Footing Roof UndFI/Slab Rough-InCeiling Water Line Slab Flaming Top Out Gas Line C Rough-In 1IG Sprinkler Foundation Insulation Sewer Ilood[Duct Reconnect Vault 13smt Damp Drywall Storm Furnace G L ' Temp Service 141SC. Masonry Ceiling Rain Drain A/C / UG Slab Sliear/Sheath Fire Spkir/Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved Approved Appr/Sdwlk Not Approved Not Approved NoLApproved Not Approved Not Approved FINAL, FINAL FINAL— ) FINAL FINAL a Ln J L C7 W J Call for reins ecti�112 d Reinspection fee of:1__ reyu;.r 1 hefore reel inspection M Unable to inspect n Inspector: — - page,e of CITY ® F' T I G A R D MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : MEC97-0470 13125 SW Hall Blvd.,Tigard,OR 97223 (503)6394171 DATE ISSUED: 1.2/01/97 PARCEL: SSI03BA-00125 SITE ADDRESS. . . : 12040 SW 116TH AVE SUBDIVISION. . . . : LERON HEIGHTS NO. 2 ZONING: R-4. 5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :039 JURISDICTION: TIS -.—----------------------------------------- I----------------------------------------- CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EMAP COOLERS: 0 TYPE OF USE. . . . :SF UNII HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. ,, . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . . 0 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 FIRE DAMPERS?. . - 30-50 HP. . . . : 0 WOODSTOYES. . - 0 GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : 0 FURN ( 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS. : 0 FURN ) =100K BTb: 0 10000 cfm : 0 Remarks : Installation of new furnace 0-1ner-- ------------------------------------------------------ FEES --------------- STEYE BAKER type amomnt by date r-ecpt 12040 SW 116TH AVE PRMT $ 25. 00 B 12/01/97 97-301470 TIGARD OR 97223 5PCT $ 1. 25 B 12/01/97 97-301,470 Phone #: Corltr-actor': ---------- --------------------- ABLE HEATING & COOLING INC 12420 SW SUMMERCREST DR ----------------------------------------- $ 26. 25 TOTAL TIGARD OR 97223 Phone #: 579--2250 Reg #. . : 001085 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Mechanical Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection 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 by the Oregon Utility Notification Center, Those rules are set forth in OAR 952-00I-80I0 through OAR 952-88I-8080. You may obtain copies of these rules or direct questions to OW by calling (50246-9187. I S S�_i e B y Permittee Sig2±tyne�.- +°++++++++++++++++++++++++++++i•+++++++++++++++++1 h+.... ....++•E+++++++++++++++++ Cal ) 639-4175 by 7:00 p. m. for inspections needed the next bi.isinest.; day +++++f.............................I......................................4-4. Plan Check#_ CITY OF TIGARD Mechanical Permit Application Rec'd By 13125 SW HALL BLVD. Commercial and Residential Date Rec'd TIGARD, OR 97223 Date to P.E. (503) 639-4171, X304 Date to DST Print or Type Permit# MF 70 Called Incomplete or illegible applications will not be accepted Name of Development/Proied Description Table 1A Mechanical Code CITY PRICE AMT Job Street Address suite# A) Permit Fee -0- -0- 10.00 Address 121 0 S 1 Bldg# city/state zip 1.) Furnace to 100,000 BTL' 6.00 including ducts&vents Name(or e_of business) 2.) Furnace 100,000 BTU+ 7.50 Owner ;ncluding ducts&vents Mailing Add as C 3.) Floor Furnace 6.00 (� J including vent ity/ late zip I PhoMe Z7 4.) Suspended heater,wall heater 6.00 or floor mounted heater Name(Varna of bus' east 5.) Vent not ncluded in appliance permit 3.00 Occupant Mailing Address 6.) Boiler or comp,heat pump,air Gond. 6.00 to 3 HP;absorb unit to 100K BUT- City/State zip Phone 7.) Boiler or comp,heat pump,air Gond. 11.00 3-15 HP;absorb unit to 500K BTU" Contractor Name 6.) Boiler or comp,heat pump,air Gond. 15.00 15.30 HP;absorb unit.5-1 mil BTU" Prior to permit Mallln Addro s 9.) Boiler or comp,heat pump,air cond. 22.50 issuance,a copy 7 ,t.�', >_ 30-50 HP;absorb unit 1-1.75mil BTU" _ of all licenses c to zip Ph a 10.) Boiler or comp,heat pump,air Gond. 37.50 are required it -ZZ >50 HP;absorb unit 1.75 mil BTU" expired in COT oregon 5p.Ast,Cont.8 erd cam_ Exp oi 11.) Air handling unit to 10,000 CFM 4.50 database Architect Nara" 13.) Non-portable evaporate cooler 4.50 Or Mailing Address 14.) Vent fan connected to a single dud 3.00 Engineercnylsu,e Zip Phone 15.) Ventilation system not included in 4.50 appliance permit Describe work New O Addition O Alteration O Repair O 16) Hood served by mechanical exhaust 4.50 to be done Residential O Non-residential O _ Additional Description of work: 17.) Domestic incinerators 7.50 16.) Commercial or industrial type 30.00 Incinerator _ Existing use of 19.) Repair units 4.50 building or property 20.) Word stove 4.50 Proposed use of 21 ) Clothes dryer,etc. 4.50 building or property_ 22.) Other units 4.50 Type of fuel-oil O natural gas O LPG O electric O 23.) Gas piping one to four outlets 2.00 a I hereby acknowledge that I have read this application,that the 24.) More than 4-per outlets(each) .50 N information given is correct,that I am the owner or authorized agent of the owner,that plans submitted are in compliance with Oreton State QTY SUBTOTAL > laws. �- - -. Signature of Owner/Agent Date 'SUBTOTAL J _ 5%SURCHARGE L S w Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL. J TOTAL Z� vnechpmt dor (rov 9 'Minimum ponnit fee is$25+5%surcharge "Residential A/C requires sse plan showing placement of unit. CITY OF TIG,ARD MEr-!!`JICAL DEVELOPMENTSERVICESPERIT 13125 SW Hall Blvd.,77gard,OR 97223 (503)6394171 PERMI-i #. . . . . . . .* MEC96-0395 DATE ISSUED: 11/13/96 PARCELz 2,SI039A-00125 Sll*'E ADDRESS. . . : 12040 SW 116TH AVE ,31JbDIVISION. . . . .- LERON HEIGHTS NO. 2 ZONING: R---4. 5 PLOCK. . . . . . . . . . : LOI.. . . . . . . . . . . . . .39 .------- ------------------------------------------------------------------------------ CI ASS OF WORK. . :ALI- FLOOR FURN. . . . : V EVAP COOLERS: 0 TYPE OF USE. . . . -SF UNIT HEATERS. . : C, VENT FANS. . . : 0 OCCUPANCY GRP. . :R3 VENTS W/O APPL: 4 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/CO14PRESSf-jRS HOODS. . . . . . . : 0 FUEL *I'Yi:,ES-.------------ 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 FIRE DAMPERS?. . : 30-50 HP. . . . - 0 WOCI.DSTOVES. . : 0 UAS PRESSURE. . . : 50-4- HP. . . . : 0 CLO DRYERS. . : 0 1\10. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : I FURN < 100K BTU: 0 10000 cfm: 0 GAS OUTLETS. : I FURN ) =100K BTU: 0 > 10000 CfM : 0 Remarks : Installation of nevi gas stove insert. Owner: ------------------------------------------------------ FEES YVONNE BAKER type amount by date recpt 12040 SW 116TH AVE PRMT $ 25. 00 DRA 11/13/96 9C-286462 5PCT $ 1, 25 DRA 11/13/96 96-286462 TIGARD OR 97223' Phone #: Contractor: --------------------------------- STAGG ENTERPRISES INC 38440 SE COUPLAND RD ESTACADA OR 97023 ------------------------------- Phone #: 727-2419 26. 25 TOTAL Reg 06542.0 RECUIRED INSPECTIONS This permit is issued subject to the regulWons contained in the Final Inspect :.on 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 suspenHed for more than 180 days. CL: I- Ln 'evin ttee Siqna0#ret t. A � -9— L L .0 $.A e, B1 y IiJ Call for inspection 639-4175 CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 039-4175 Busiress Phone: 639-4171 Footing Rain Drain Coder/Service FINAL: Foundation Water'_ine Ceiling -Plumb. Post/Beam Mech, Shear/Sheath Framingech. Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect. Post/Beam Strutt. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer s Line Appr/Sdwik Reins. Other. (,, �___ Date: 1 ( �{ A.M. P.M._4 Entry:- _— Address: \Zy 4o Sw__.__._� Tenant: _ Ste: MST: //��� � BUP: Con/Own: U �'� ��"��i1!- MEC:E Q S~(� PLM: ELC: THE FOLLOWING CORRECTIONS AIRF REQUIRED: ELR: ---- �-� CL L Y - -- __ - J Inspector: ' t� Date: J _-PPROVED —DISAPPROVED/CALL FOR REINSP. CF CO 1 Plan Check 0 CITY OF TIGARD Mechanical Permit Application Reid ByL 13125 SW_HALL BLVD. Commercial and Residential Date Reid_11-15-7 TIGARD, OR 97223 Date to P E. (503) 639-4171, X304 Date to DST Print or Type Permit r Incomplete or illegible applications will not be accepted called M.ms«o.rwp„�nvProNa Descnpnon Table to Mechanical Code ary PRICE AMT Job 5UVM AddMU tee+ A) Pe"Fee -0- -0- 10.00 Address _-1("qO r , V, 4, zo B) Supplemental Permit 3.00 1.) Furnace to 100,000 BTU 600 Owner `Lc,f. G YI►vrt,✓ ( ind.ducts&vena M oAeartssa / T?� 2.) Fumace100.000BTU7,50 a , to ind.ducts d vents c Ph" 3.) Floor Furnace 6.00 T' f'7 . 6 it md.vent N.nw (W rwrw or ous.»ssl 4.) SuspendW heater,war heater 6.00 ] d,1 `r or door rnourrted heater Occupant Ma"AOW*u 5.) Vent not inti in 3.00 44+1Aance pew cowsrw ZIP Moor»' 6. Boiler or camp,heat pump,air pond. 6.00 to 3 HP.absorp unit to 1 OUK BTU Nartr 7.) Boder or comp,heat pump,air cond. 11.00 ar/' 3-15 HP abswp urW to SOCK BTU Coriftactor ,d~& ) lD 6.) Boiler or comp.heat pump.air avid. 15.00 rL 15,30 HP,at"M unit.5-1 mi BTU AesM Lin f Cm. ZIP ap PhOW 9.) Boder or comp,heat pump.air gond. 22.50 �� 1 r �l -,-4 j V 30.50 HP;absorp unit 1-1.75 and BTU orepon C. cont Loa OMe io.) Boder or comp.heat U C _J PrP.am cond. 37.50 >50 HP:absorp unit 1.75 and BTU COT Tax or him a EqL OW �� 11.) Ar hanctli g tN*to 4.50 10.000 CFM Architect Name 12.) Ar ti rW*q unit 7.50 10.000 CTM+ or U+w Ams 13.) Non portable 4.50 evaporate cooler Engineer c"1"state Phone 14.) Vent f n connected 3.00 to a sftle duct Desc nbe work New O Addition O Alteration Repair O 15.) Venblabon system not 4.4 to be clone Residential Non-residential CV included in appfiance perp it AAadional Description of woik 16.) Hood served by / - 1 mechankml exhaust 4.50 Is� /N✓I Jou- T►U/�J L�f j�Jrvf ��vT 17) Dornesuc ff"erat0rS 7.50 Extst,na use of 18.) ConxrwctW or industrial ` 30.00 building or property_ ypeirr� 19.) Clothes dryers,etc- 4.50 CL _ Proposed use of 20) Other unit, 4.50 N building or property �� 1(J I h Type of hies-oil O natural gas LPG O electric O 21) Gas pipeig one to four outlets / 2.00 �iG _j I hereby adrnowlerge that I have read this application,that the 22) More than 4-per outlet (each) 50 in mfomtation given is coned,that I am the owner or authorized agent of tC.0 the owner,that plans submitted are in compriance with Oregon State QTY.SUBTOTAL laws. Signature of Owr_ti?Agent Data 'SUBTOTAL -� 5%SURCHARGE Contac'Person Name M PLAN REVIEW 2S%OF SUBTOTAL TOTAL t1idstYnechpmt.doc 'IYUrwnun permit fee is S25+5%surcharge Rev 7196