12525 SW 121ST AVENUE 1
ADDRESS:
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CITY OF 11,3ARD BUILDING INSPECTION DIVISION ('
24-11our Inspection Line: 639-4175 Business Phone: 63S, 4171
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Date Requested: - 1 � - q,? A.M. P.M. _— MST: _
Location: off.�� W—IA(� i;u , 0,joe--, - BiJP:
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Tenant:__ _� Suite: --Bldg- _ /MEC: G7" C
Contractor:_V� �� L2 -Phone: -& q3 -n156 ItIM CFL,M:
Owner:-,-- —Phcne:
r� oZ- /y Cf7 Com,
BUILDING BLDG(con't) PLUMBING MECHANIS ELECTRICAL, SITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footin,; Roof UndFI/Slab Rougb-In A ,Oli' Ceiling Water Line
Slab Framing fop out 'Gns ,me / Rough-In 11G Sprinkler
Foundation Insulation Sewer H u c t Rewnnect Vault
13sn11 Damp Drywall Stormurnac-G Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr Heat Pump LOW Volt _
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved `�I Ap ro Not Approved Not Approved
FINAL FINAL FINAi. FINAL FINAL
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n Call for reins I•cti�/ Cf1 Reinspection fee o $_ _____required before next inspmtion l lnahle to inspect
Inspector llate ._,�'=�-�S S Page__. _of
CITY C F T I G A R ® MECHANICAL
DEVELOPMENT SERVICES PERMIT
PERMIT #. . . . . . . : MEC97-0490
13125 SW Hall Blvd., Tigard."R 97223 (503)639.4171
DATE ISSUED: 12/19/97
PARCEL-: 2SI03BC-00100
SITE ADDRESS. . . 13W 121ST AVE
SUBDIVISION. . . . : ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . .. . JURISDICTION: URD
------------------------ ------------------------------------------------------------
CLASS OF WORK. . :NEW FLOOR FURN. ., . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS— : 0
OCCUPANCY GRP. . : R;3 VENTS ln"/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL 0-3 HP. . . . : 0 DOMES. INCIN: 0
-PG 3-15 HP. . . . : 0 COMML. INCIN- 0
MAY INPUT: 0 BTU 15-30 HP. . . , - 0 REPAIR UNITS- 0
FIRE DAMPERS?- - 30-50 HP. . . . : CA WOODSTOVES. . : 0
GAS PRESSURE. . . . 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF AIR HANDLING UNTTS OTHER UNITS. : 0
FURN ( 100K BTU: 1 10000 cfm: 0 GAS OUTLETS. : 0
FURN ) =100IJN BTU: 0 10000 cfm : 0
Remarks : Adding gas furnace to existin; WD.
Oviner: FEES
R. W. BREITENSTEIN type amoi.(nt by date reept
12525 SW 121ST AVENUE r,RMT $ 25. 00 TiH 12/19/97 97-301917
'TIGARD OR 97223 5PCT $ 1. 25 TJH 12/ 19/97 97--301917
Phone #: 503-590--5163
Contractor-:
...........
$ 26. 25 TOTAL
Phone 4:
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REOUIRED INSPECTIONS
This permit is issued subject to the requlatinns contained in the Final Inspection
Tigard Municipal Code, State of Ore. Sperialty Cedes and all other
applicable laws. All work will be done in accordance with
2pproved plans. This permit will expire if work is not started
within 180 days of issuance, or if cork is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
2; adopted by the Oregon utility NWficF.iia;i Center. Those rales art
set forth in OAR 952-901-0810 througt, OAR 952-MI-0080. You may
obtain copies of these rules or direct ques'iion,; to O11NC by calling
(503)246-9187.
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,stip By: Permittee Signatitre."
++4-4.................. ++++++++++t•+++++++++4 . ++++++++++++++++++++++4•+ ..........
Call 639-4175 by 7:00 p. m. for inspections needed the next b1_19iness day
+•++++4++++++i......4........................ .....4.....................4..........4
12116.97 TCF. 15;28 FAX 503 598 1960 CITY OF TIGARU [zoo.,
Plan C-leck 04A
-CITY CF TIGARD Mechanical Permit Application Reid a;
13125 SW HALL BLVD. Commercial and Residential Date Rec'd_j loi�o►�
t_,_
TIGARD, OR 97223 Data to P E. 01A
(S03) 639-4171, x304 Date'o DST I2r ±n U
Pri;tt or Type Perm'c a
Called ,NhL'v�'
Incomplete or illegible appiication3 w1ell not be accepted _
�.. � v Nellie pr Deroopmonver�o� -1 Desctlptron
N i Tadle 1A Mechanical Code QTY FRICE WT
Job Sheett Adrxeusurer A) Permit Fen -0.- -0- 1J.00
Address 12625' S.Ld.12/ ''—rAvoor.
9wga cmc,uta zip 1,) Furnace to 100,000 BTU 600
T rA, � ,22 incliningd
dus&vents 6,0 0
v(or name if burns 2.) Furnace t00,00C BTU+ -- I 750
Owner /�. 1J Br'Ct C►'1G111 — Including ducts'.. . 1
Madrng.,care:. ,y T'�1 3./ loor Furnace
2 S�S S 1 %7! /r V`�= including vent
cnyr5 ate c� v nonr, 3
6 00
4.) Suspended neater,wall healer
T r CJ✓ a noor mounted heater _
Ng..-,,or name of busflq•! S.) Vent not Included in apriienCx permit 3 00
!2. W. $rtr 5t�fn
Occupant Maoiling d m
7r 6.) Railer or cap,heat Gi�• , 2'r wnd 6.00
12 S? $e.1 / _.i�/Q+.rP to 3 HP;:text unit 130K BUTS
cifyisme o I Phone - 7) Buller or como,hi.3 pum- par Gond. 11.00
Q r (//• (1-5t 6..z 1 .115 HF"eheerb trio til?UUK krT,.l"
Contractor Nn 8.) Boiler or comp,hast rump.air Gond. 16 00
L F 16J0 HP;at orb unit.5-;mil BTU-
Pnorto pem+R -dine Md— 9.) Cloibr ore- nl oump,air conA. -- -- 22 r0
waanre n rnnv T 4;J1 HP : .,n+ ,-+7111mi1 iiT1P-
crall licenses 5713tats o e 10.) Boiler or ,.,n ' pump,ah 31,cond � "0
We required t `90-Sih >50 HP; it 1.75 rill ST'J-
_
exp reo in COl" recon Garet Ccnt 031`0 Lia fico Data 11.) Air handling unit to 10.000 CF\1 _ r 4 50
database
Arahiteet t1.) NI•n portobto evaporate 000br 1 ro
or Mailing Adareei —^ 14) Vent fan connected!o a single dug 3.00
Engineerdyr5ute �Lo Phone 11,) enhlation system not included al d 50
applanae perm3 _
Describe work New O AcditlonX A,tarapon C Repair C 1E) Hood::erved by rnechanioal Pctv1 ist 4 50
tc be done Reside nt'a'0 Non-residential 0
Additional Descnplior 0 wo. ' 1 J ornestle incinerators 50
ACTAS FtAi-r1 OLic,e _
18.) Co nmercial or industrial type 3000
_ Incirxiatoi
E 'vtrnp L11 110 n �� .0 1G) emir unrtS d 50
�ikim11
50b,
malting ol'Yl� re.4tL�Q�j�o�
T) 1'CG Stove 4.5(U
P.)posed use of 21 ) Clothes dryer,ex I 4.9u
b d1ding or prcperh,
^7 (llh�r nrie � J I S(1
ype or rue -oil C. natuoll pia LPG•a vW 11i;C, 23.1 uN VlViry v iv W rvvi v� t:lb .l Ad
nareby a ,yw !ge that I have read this application,t"et the -t4.) We than 4-per ottlets(each) io I
n i Informabcn given.s caned,that i am the owner or Authonred age-it d
tie owner,that plans submitted are.n compliance With Oregon State QTY SUBTOTAL /^
Laws
Signature of Ovnler/Agil Date 'S 0 n�p
5Ye SURCHARGE
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Crintaut Penon Mame Phorw PLAN REVIEW2-57 OF UB 7AL.
413 -0I C�-�,
TOTAL
_ .57o
0•1` irhprnt doe (rev g - p r L�g.� hMn!mum parmlt kw b S25+5%surcharge
�' 301. T "Resiciantlal AJC requlms elle p'an showing placement of unit
1`4,- 6q l 210-7
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: ` ` -1 l -( U A.M. P.M MST:
Location:_ I c� C / _ BUP:
Tenant:` Suite:_ Bldg: s►g,1_TING
Contractor: Phone: PLM:
Owner: --rLIZ (o D!.7 k lj Phone: S"i U - S_/
BLR:
SIT:
BUILDIING BLDG(con't) PLUMBING �'�4IECHANICAI,` _ WE
site Post/Bcam Post/Beam Post/Bewn Cove. , ice Sewer/Storm
Footing Root' Und /Slab Rough-In Ceiling Water Line
Slab Framing Top Out Gas Line Rough-In UG Sprink:zr
Foundation Insulation Scwrr Ilcxw)tict Reconnect Vault
Bsmt Damp Drywall Storm =urnace "Temp Service MISC.
Masonr, Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire Spklr/Alin Crawl/I'ound Dr I feat Pump Love Volt
Approved Approved Approved Annoved Approved
Appr/Sdwlk Not Approved Noi Approval Not A roved Not \,)proved Not Approved
FINAL FINAL F_IN_ATb2 7iNAL FINAL
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C3 Call for reins0 Reinspection fee of S required before next inspection O Unable to inspect
Inspector �_ Date: Paple of