11935 SW 128TH AVENUE '.
ADDRESSA
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CITY OF TIGAtRD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business line: 639-41711 — —
BUP -
Date Requested — AM _PM ---- BLD _
Locatin It q.3 S Suite - MEC
Contac` Person _— Ph —_ PLM _
Contractor Ph _ SWR —
BUILDING -----� Tenant/Owner _ ELC -
Petainino Wall ELR
f=outingAc�-'_'_ _ -.--
Foundation PS
Ftg Drain NOT REQUESTED SGN
Drawl -)rain In: FOUND DURING RESEARCr —
Slab — NO INSPECTION(S) FOUNF1 IN FILE SIT
Post t Beam
Ext St Bath/Shear _—_--
Int Shaath/Shear
='aming --— —�. --- ---
nsulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling �� - -- -- - -
Roof
Misc:____ -- - - — --- — --- ---- ..- --- - - - --- --
Final
PASS PART FAIL --- - --- -- --- .—. --- --- ------- --
PLUMBING
Post 8 Beam -- ----- �— --- —
Under Slab
Top Out
Water Service Y
Sanitary Sewer --- ---------- --- -— - —
Rain Drains
Ficial
P PUT ' P1 L
GHANIC.A&
Post& Beam —_----
Rough In
Gas Line ----- - - - - ---_ --- ------------
Smoke Dampers
PASS PART FAIL
ELECTRICAL -------- - -- ----- ---..--- ------- — --- -
Service - ---- ------- -- -- -
Rough In
UG/Slab __—__- — --_-- --- - -- — —
Low Voltage
ri- Fire Alarm --- — - ------- ---
`" I r anal
PASS PART FAIL —__-- - —
_, SITE
Backfill/Grading --�
'-' Sanitary Sewer
1i1 Storm Drain I ] Reinspection fee of R— --required betore next incpec:ion. Pay at City Hall, 13125 SW Hale Blvd
Catch Basin
Fire Supply Line ( I Please call for rein;,pection !<f=:--___ -- [ ]Unable to inspect-no access
ADA
Approach/Sidewalk Date InspectorExt
Other - — - -
Final
PASS PART FAIL 00 NOT REMOVE this InsprXtion record from the job site.
CITY OF TIGARD MEC:-IANICAL_
DEVELOPMENT SER`JICESr'rRMTT #. F,ERIriIT
: MEc96-04 ,5
13125 SW HallBlvd., Tigard,OR 97223 150-3)639.4171 DATE ISSUED: 12/12:1/96
�
ARCEWL.: 1 S 1 r 3DD-1 G800
'i]:TE A1;'L�FZF"Ssa. , . 119-�; SW 1 -'t�Tl-I AVE E^PIREL�/
>UBD I V I G I ON. . . . : V I L_LAGE AT SUMMER LAKE PARK 5 7.0N I NG: R-4. 5
'LOCK. . . . . . . . . . . LOT. . . . . . .. . . . . . . . =04
C,L.ASS OF WGRK.. . :PDD FLOOR F•URN. . . . : EVAPCGOI._ERS: 0
TYPE OF' USF., . . . :SF UNIT HEATERS. . : 0 VENT FANS— : 0
OCCUPANCY JRP. . :H2 VENTS W/rl AF'PL..: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYF'F ,,_.__–_.._._._....___ 0-3 HP. . . . : i7' DOMES. I NC T ISI: 0
: ,/GAS/ ! / 3-15 HP. . . . 0 COMML. I NC I N: rd
MAX INPUT- 0 BTU 1.5--30 HP. . . . ; 0 PEPA I R UNITS-. 0
FIRE DAMPERS?. . : 30--50 HP. . . . 0 WOODSTOVES. . : 0
GAS PRESSURE. . . 50+ HP. . . . : k) CLQ DRYERS. . : 10
NO, OF UNITS- ------ -- AIR HANDL_1WG UNITS OTHER UNITS. : 0
FURN ! 100K BTU: 0 t- 10000 cfm : 0 GAS OUTLETS. : 1
TURN ) =100K BTU: 0 ) 1.0000 cfm : 0
fremat-ks : ridding gas piping
7wrler-: --__.--.- -._._._.______.---.__.___________ FEES
DAVE KOEP type amrt.tnt by (late r-ecpt
11735 SW 128TIl AVE PIRMT $ 25. 00 TAT 12/12/96 96--28'7G'70
5P7T $ 1. 2*5 TAT 1211r'i`36 136-287F,77G)
TIGARD OR 97224
F'hrcne 1#:
Conti^actor,: --_---..__---_,—_----__.----_---_--
COI.AJMBIA HF_'PTING
PO BOX 230397
TTCARD OR 97281
PI•i o n e it: 26. 25 'TOTAL._
Rey #. . : 76359
REQUIRED INSPECTIONS
_...._ _
This pernit is issued subject to tt:� regulations contained in the Gas tine Insp
Tigard Municipal Code, Statr! of 4.0. Specialty fides and all other Mech,,nical Tnsp
app]Ica"le laws. Al work will he done in am,dance with Misr_. Insprection v�
app,oved plans. This pewit will expire if eor•k is not startrd F i nal I n s>pect i ot)
within 180 days of issuance, or if work is suspended for more
than 180 days,
F pe1...mittecSi.y-�� 7 44
s,jerd By
C 1 for inspection - 639-4175
Cit; of Tigard MECHANICAL PERMIT Planck/Flec. #
13125 QVV Hall Blvd. APPLICAT JN Permit #
Tigard, OR 97223
(503) 639-4171
K '�+ � �ascripuon-
UU I Table 3A Mechanical Code —_ QTY PRICE AMT
Job 7 r1`� � Av 1) Permit Foe o0
Address _ '� 10.00
ap
21 �- 2) Supplemental Permit 3.00
urnaca 16713177171=-
1)
o tR77171 CT-1) incl. d-icts&vents 6.00
"' umaceB I U +
Owner I `j(to (,?�i� � ���-6>3 `In 2) incl. ductc s vents 7.50
rr� oor url nan-
I( Cl �It �� 3) inc;. vent 6.00
usperidW.,uater, wa mater
4) or floor mounted heater 6.00
Occupant en no 3.n—
5) appliance permit 3.00
"ORepair o eating, re ng — --�
_ 6) cooling, absorption unit 6.00
� � � Toiler-or Gump, ea pu p,acon-r ---
9 —
Sn `C• X 7) to 3 HP;absorp unit to 100K BTU 6.00
of er or comp, hedt pump,air con —
i. L - ,n• ,l 8) 3-15 HP; absorp unit to 500K BTU 11.00
Contractor � �?�39� �7C �
1 ' i er or comp, ea pump,air con .
1( t I 6)/r:� 9) 15-30 HP;absorp unit .5-1 mil BTUI 15.00
'/&~ z' y Boiler or comp, eat pump, air cond.
/ (��� .A,Q' 10) 30-50 HP;absorp unit 1.1.75 mii BTU X2.50
sere y ac ow ge7a T aiT-vn rea ap
is p icaFon, ,a o" i er or comp, ea pump,air con — —"
information given is con -t,that I am the owner or authorized agent 11) > 50 HP;absorp unit 1.75 mil BTU 37.50
of the owner, that plans submitted are in compliance with State Air handling unit to --
laws, that I am registered with the Construction Contractor's hoard, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, it handling unit—
please give reason below.) 13) 10,000 CTM 4 7.50
— on portable ---
14) evaporate cooler 4.50
—W@niTn conne�ecT— --
15) to a single duct 3.00
—
a- Ven'blaUon system
'
_� 16) included in appliance permit 4.50
Hood serled By _
17) mechanical exhaust 450
D
escribe wor new itian Q a tT auon-ID—repair Commercialor industrial
done residential O non-residential O 18) type incinerator 30.00
ng use a ter i.e.,wo s uve,wier
building or property _ 19) heater, solar, clothes dryers, etc. 4,50
Proposed use of
building or property 20) Gas piping one to four outlets 200 -
LL 21) More than 4-per outlet
L; Type of fuel oil Q natural gas Q LPG O electric O
1--
V)
~ Minimum Fee$25.00 SUBTOTAL �j.Q
J PERMITS BECOME VOID IF WORK OR CONSTRUCTION _
t AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5%SURCHARGE �.�
IF CONSTRUCTION OR WORK IS SUSPENDED OR —
w ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME
PLAN REVIEW 25%OF SUBTOTAL
J AFTER WORK iS COMMENCED _-
Special Conditions ---- r
Date issued by
►.MiCMMR
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