12605 SW 128TH AVENUE i �� � .. . �6 � - •� �. �Vii. t_
� e
1
I
op
lb
(p 05 tS
i
.. .
I
Q
CITY OF TICARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Bur,iness Phone: 6394171
Date Requested: Z.- 7 A,M. a Y.M. MST:
upati,eu: __1_ll-,(J-�_-•S u /2 � Tu 1�SL:�_- -- —� BUR
Tenant:` _ Suite:_ Bldg: — MFC: 7-U 71-
Contractor: KG l h1" c E Phone- PLM: _
<hw< f}w 0 b L C f h,)nc: -
CK�c� FaR AQPPo✓0n 31-61T-o r-r y ,vwccTj/L Q- - — FT R:— r -
��/� ffOLL /A,. -LDO/L ___E
__ SIT:
BUILDING BLDG(con't) PLUMBING <-MECHAV CICI A ELECTRICAL SITE
Site PoRt/I:-atm Post/Beam 1''=713t`. -n� Cover/Service Sewer/Storm
Footing Hoof Undl'I/Slab Rough-In Ceiling Water bine
Slab P , .ting Top Out Gas Linc Rough-In I JG Sprinkler
Foundryion h.;ulation Sewer I hxxi/Duct Reconnect Vault
Bsmt Damp I -./wail Storm Furnace Temp Service MISC.
Mesor+y Ceiling Rain Drain A/C UG Slab
Shcar/Sheath Fire Spklr/Alm Crawl/Pound Ih 1 feat I"w') Low Volt
Approved ApprovedA1), 0 1 tom% Approved Approved
%ppr/Sdwlk Not Approved Not Approvedof/,I;proved Not Approved Not Approved
FINAL FINAL TM FINAL FINAL
t
W
Cell for reinspection D Reinspection fie of S required before next inspection ❑Unable to inspect
Inspector: r `_ _ Date.: ^�� ��� Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business �q�e: 6394171 \
L`ste Requested: A. . V7�� P.M. MST: _
Location:_� �' lC �� L .�_. BUP:
Tenant: Suite: �Bldg: MEC: ,_
Contractor: _ Phone: <� � /�G� PLM:
Owner: _ Phone: ELC:
ELR:
_ U SIT:
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/fkam Post/Beam Cover/Service Sewer/Storm
Footing Roof' lJndFI/Slab Roup n Ceiling Water Line
Slab Framing Top Out `Gas Line, Rough-In IJG Sprinkler
Foundation Insulation Sewer 1lood/Duct Reconnect Vault
Bsrnt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I lent frump Low Volt
Appmved Approved pprtiv Approved Approved
Appr/Sd%S•Ik N:,t Approved Not Approved IT77pproved Not Approved Not Approvea
FINAL FINAL FINAL FINAL FINAL
-- r
Cto
J
1 Call for rein.Qpection D Reinspection fee of S {_r uired bre next inspection 173 Unable to inspect
Inspector: ' __ _ Date: / �� _ Page__-_ of _
C i TY O F T i G A R D MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 PERMIT #. . . . . . . : MEC97-0128
DATE ISSUED: 05/12/97
PARCEL: 29104AD-02'000
SITE ADDRESS. . . : SW 128TH AVE
q(-JRD I V I S I UN. . . . : BELLWOOD ZONING: R-4. 5
111-OCK. . . . . . . . . . : LOT. . . . . . . . . . .. . . :47 JURISDICTION: TIG
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF* UNIT HEATERS). . : 0 VENT FANS. . . : 0
OCCUPANCY GRF,. . : R3 VENTS W/O APPI- : 0 VENT SYSTEM'-): 0
STORTFS. . . . . . . . . 121 BOTL ERS/C.OMPRE9SORS HOODS. . . . . . . : 0
FUEl TYPES---._--------- 0-3 HP. . . . 0 DOMES. IN'31N: 0
:GI.S 3-13) HP. . . . 0 CONvil— INCIN: 0
MAX ' NE11-IT- 0 STI-) 15-30 HP. . . . 0 REPAIR UNITS: 0
FIRE DAMPERS!. . : 30-51L. HP- -- 0 WOODSTOVES. . : 0
GAS PRESSURE. . . 50+ HP. . . . : 0 CLO DRYERS. . : 0
No. OF AIR HANDL ING t..)N I T!-) OTHER UNITS. 0
FURN ( 100V, BTU: 0 1.000171 r--fm : 0 GAS OUTLETS. 1,
FURN > =100K. BTU: 0 10000 cfm: 0
RemAv-ks : Installation of gas stave.
7 r -1 ---_------------.
RANDY LU tyPEA a mti ii n t e r-ecpt
J
1 ,1-605 SW 128TH AVE rRMT $ 25. 00 L 5/12/97 97-294459
TIGARD OR 97;::23 5PCT $ 1. 25 I)Rn 09/1.2/97 97-r-` 4459
Phone #;
Contractor: -----------------.-__--_-__--_
HO1._MES INSTALLATION SERVICE
RAYMOND FLANDFPS
9-1 ,00 SW 1419T AVE #55
PFAVFRTON OR 97005
Phone It: $ C-_'6. 25 TOTAL
Pen 001024
------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas I inp 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.
e r-M j.t t e e tur
I s .1 P d
Call far insnec-tion 639-4175
GONE
Plan ChecK r
CITY Cc TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Cale Recd
TIGARD, OR 97223 Date to P E.
(503) 639-4171, x304 Date to DST_
Print or Type Pemi;*,of
Incomplete or illegible applications will not be a: Called
cepted --
Name of DevmopmenaProject Description
Table 1A Mechanical Code OP, PRICE - T
Joh Street Address Surfer A) Permit Fee -0- -0- 10 00
Address ��� ;�j (, r _.0/I
Bidyr City/ tate Zip 1 ) Furnace to 100.000 BTU 600
including ducts&vents
Name-.or name of husinessi 2) Furnace 100.000 BTU+ /50
Owner S- L including ducts&vents
Mading Address 3 i Floor Fvmace 600
ncluding vent
C tpState - yip Pnone 4) Suspended heater,wall heater 6.00
or ftonir mounted heater
ame(of
JJname of busy " 5) Vent not included in appliance permit 3.00
V _
Occupant Mailing Address 6.) Boder or comp,heat pump,air cond. 6.00
to 3 HP, absorb unit to 100K BUT'"
:m, state 2 p Phone 7 j Boder or comp,heat pump,air cond 11.00
3-15 HP absorb unit to 500K BTU"
Contractor Nr.ne 8) Boder or comp,heat pump,air cond. 15 00
(Pnor to - 1La� (NSi RLL [ ( 15-30 HP.absorb urnt.5-1 and BTU"
issuance Mailing Address 9) Boder or camp,heat pump,air nand. 22 50
applicant L-A p 30-50 HP absorb unit 1-1 75md BTU" _
must provide all atyrstareZlp e to) Boder or comp,hea.pump,air cond 37 50
contractor ?, O Phonj >50 HP. absorb unit 1 75 and BTU"
I license Oregon Const Cont.Board Lie r Exp Dat 11.) Air handling unit to 10,000 CFM 450
information ( •_�t L
for COT (:Or Business rax or Metro r Expo 12) Air handling unit 10.000 CFM 750
database) LI I
Ar0itect Name 13) Non-portable evaporate cooler 4 50
or Mating Address 14) Vent'-.I connected to a single duct 300
Engineer C,ty,State Zip Fhone 15.) Ventilation system not included in 4 50
appliance permit
Describe work New O Adf tan Alteration O Repair 16.) Hood served by mechanical exhaust 450
to be done Residential 6Y Non-residential O _
Additional
l� C-1•Description of
work
L' 17) Domestic manerators i SO
Aim I ) s QS\" To k1 R tic 10 18 ) Commercial or inaustnal3000
$ c_ - incinerator _
Existing use of 19 1 Repair units 4-50
building or property � .�
1I20 i Wo,)d stove 450
Proposed use of 21 1 Clothes dryer,etc. a 50
building or property
2Z) Other units 450
Type of fuel-oil O natural gas V LPG O elecinc O 1) A-1 231 Gas piping one to four out) s 200 7
CL9 �Q,L_ "C y0X.)
I hereby acknowledge that I have read this apioxation that the 24) More thin 4-p outlets each) 50
nformatior,given is correct.that I am the owner or authorized ayent of
the owner.that plans submitted are in compliance with Oregon State QTY SUBTOTAL
c laws
w ftl r ture of Owner/Agent Date 'SUBTOTAL
•,
5'b SURCHARGE I
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
F�CNR '\ LTOTAL
1 dst'rnechpmt doc ire>. 9 Minimum permit fee,s S25+5"e surcharge
-Residential ArC requires site plan showing placement of unit