12110 SW 123RD COURT :i
ADDRESS:
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CITY OF TIGARD BUILDING INSPECTION DIVISION FAST
24-hour Inspection Line: 639-4175 Business Line: 639-4171 BUP
Date Requested rJ �s _AM PM v �6 BLD
I-ocation_ ( � �_� Z. rA Suite ME-C
Contact Person L Ph ��- 5 S 7 PLM —_
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR —
Footing Access: ' f
Foundation FPS
Ftg Drain SGN
Crawl D;yin Inspection Notes: t,-a/��
Slab
�� C-'Y - — 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 ------ --- -------_.�_"___._-_
Rain Drains
Final
PASS PART FAIL
CAL—^
Rough In
r
ias Line -— - --- -- -- - -- —T �� _
Smoke Dampers
;,. PART FAIL
CTRICAL ----- --__- ----- --- -
Service
Rough In
UG/S!ab
Low Voltage
~ Fire Alarm
Final
►- PASS PART FAIL
SITE
IwE Backfill/Grading -- -
U5 Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ )Please call for reinspection RE: - _ - -_ [ J Unable to inspect no access
ADA
Approach/Sidewalk
Other Date d- Inspertor Ext
Final
PASS PART 'AIL 00 NOT REMOVE this inspection record from the job site.
CITYOF TIGARD MECHANICAL OERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00008
13125 SW Hall Blvd.,Tigard, OR 97223 (5 - I N A LPARCEL 2S103BB-'10700DATE ISSUED: 1/7/00
SITE ADDRESS: 12110 SvV 123RD CT 008PM
SUBDIVISION: YE OLDE WINDMILL ZONING: R-,' 5
BLOCK: LOT: 027 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COCII.ERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS WIO a.PPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP:� DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FUR" >=100K BTU: <= 10000 cfm:
GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of new ,gas furnace and associated gas piping.
Owner: FEES
LEE, MARTIN LAND Type By Date Amount Receipt
CAROL A PRMT DEB 1%1/00 $50.00 00-32.0987
12110 S\N 123RD CT 5PCT DEB 1/7/00 $4.00 00-320987
TIGARD, OR 97223 --
Total $54.00
Phone:
Contractor:
AAA HEATING + COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 REQUIRED INSPECTIONS
Gas Line Insp
Phone:284-2173 Heating Unt Insp
Reg #:LIC 00000222 Final Inspection
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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 perrv;it 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 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by
calling (50 )246-9189. /
Issue B /`y �Permittee Signature:
Call (50:i) 63 178 by 7:00 P.M. for inspections needed the nex business day
CITY Or TIGA.RD RESTRICTED ENERGY ELECTRICAL APPLICATION Recd _
13125 SW HAL[_ 131 VD //) � Date Rec d- —
rIGARD OR 97223 r��. hU PRINT OR TYPE
V- 503-639-9171 X304 0$3-e)Fa i(,3 -0,?- RECEIVED Permit
- 503-598-19(30 INCOMPLETE OR ILLEGIBLE APPLICATIONS Cust.Call'd:
WILL NOT BE ACCEPTED � ----
Nam'e)of Development Protect TYPE OF WORK_ II�� D -RESIDENTIAL ONLY
—
7 Restr ryyj
:. �-• • 560.00
(FOR ALL SYSTEM}'L'�PiVIEfV'f .
JOB Street Address Ste#
-7
ADDRESS zqrg0 L —J I Check Type of Work Involved:
C' /State Zip Phune ❑ Audio and Stereo Systems
Na ❑ Burglar Alarm
4 LCA1 uz_
OWNER Mailing Address ❑ Garage Door Opener'
City/State Zip Phone# ❑ Heating,Ventilation and Air Conditioning System'
Name ❑ Vacuum Systems'
ADT SECURITY SERVICES,INC
2815 S.W 153rd DR.
❑ nther-
:;ONTRACTOR M.3iling Address `FAVER TON,OR 97006
50' TYPE OF WORK INVOLVFD -COMMERCIAL ONLY
Prior to issuance a City/State Zip Phone# Fee for each system........
:opy of all licenses (SEE OAR 918-260-260) _ $60.00
are required if Oregon Contr.Brd Lic.# Exp Date
expired in C O T j qq - Check Type of Work Involved:
data base) E!pctrical Contr.Lic.# Exp.Date
�1- 'O ElAudio and Stereo Systems
C.O.T or Metro Lic.# Exp.Date
-------
Owner's Name ❑ Boiler Controls
❑
OWNER- Mailing Address _ Clock Systems
APPLICANT _ ❑ Data Telecommunication Installation
f7ity/State Zip Phone#
❑ Fire Alarm Installation
nis permit is issued under OAE 918-320-370.This applicant agrees to
ake only restricted energy installations(100 volt amps or less)under this ❑ HVAC
�rmit and to do the following.
❑ Instrumentation
Only use electrical licensed persons to do installations where required.
Certair,residential and other transactions are exempt from licensing. ❑ Intercom ar.d Paging Systems
These have asterisks('). All others need licensing,
Call for inspections when installation under this permit are ready for ❑ Landscape irrigation Control*
inspection at 503-639-4175: ❑
Medical
Purchase separate permits for all installations that are not ready for an ❑
inspection when the inspector is out to inspect under this permit, Nurse Calls
Ass11m responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
irsr.ector are done,and,
® Protective Signaling
Assume responsibility for calling for a final inspection when all of the
t corrections are completed ❑ Other
vm —
rmits are non-transferable and non-refundable and expire if work is not
F mrted within 180 days of issuance or if work is suspended for 180 aays
_ .`+Number of Systems
J
its person signing for this permit must be the applicant or a person No licenses are required Licenses are required for all other Installations
thorized to ind the ap 'Tnt.
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FEES:
FEES gn9
ENTER Q ,01,P S�_�
SCK
0.SURCHARGE(.05 X TOTAL ABOVE)
ithority if other than Applicant -- TOTAL
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