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1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Liro: 639-4171
C BUP
,_Date Raioested__ L AMPM BLD
Location /c/ 2-3$ <-.6<,) /�r?ay.0 C& L.ea{J Euite MEC _
Contact Person 7,,/Y) T Ph _ -Sl q— 11-4 7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining WallI ce) ZL Z
Footing
Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: ,
Slab :• V 4-41 �_n - SIT
Post&Beam — - -
Ext Sheath/Shear
Int Sheath/Shear -
Framing _
Insulation -- -�--- --�---
Drywall Nailing _---•----------_.----_-.------_-_._
Firewall
Fire Sprinkler --y�
Fire Alarm
Susp'd Ceiling —�_---
Roof
Misc
Final 2Z
PASS PART FAIL --------------- _- �- - -
PLUMBING
Post R Beam ---- -- - ----- ----- -----..
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final _ ---.- ------- -- ---..-�.--------------
PASS PART FAIL
MECHANICAL
Post G Beam ..--
Rough In
Gas Line ----____--
Smoke Dampers
Final --
PASS PART FAIL
ELECTRICAL ----------------__------- ----------------- --_----__.
Service - -- --- - _—._ _---- ---- -
Rough In ��„ -_.-----------_- -.- -- ------ - _ --------- -`- --
LIG/Slab
Low Voltage
Fire Alarm ------ ------ ----- -- - --..._
F.
P S PART FAIL ------------- -._- �--- ---
S
Im-
Backfill/Grading --- _-- -
San tary Sewer
Stor•n t:,An ( j Reinspection fee of g required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( Please call for rei spection WE: ( j Unable to inspect -no access
ADA
Approach/Sidewalk
Othef Date 9 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITYOF TIGARD RESTRICTED EN RIGY
DEVELOPMENT SERVICES � PERMIT#: ELR2000-00222
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171 DATE ISSUED: 9/27/00
SITE ADDRESS: 14235 SW FANNO CREEK LP
PARCEL: 2S 112BB-08300
SUBDIVISION: COLONY CREEK, ESTATES NO.2 ZONING: R-7
BLOCK: LOT: 066 JURISDICTION: TIG
Proiect Description. Installation of restricted energy for heating system.
A.RESIDENTIAL B. COMMERCIAL
AUDIO& STEREO: AUDIO& STEREO: � INTERCOM & PAGING:
BURGLAR ALARM BOILER: I-PNI;SCAPE/IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: X DATA/TELE COMM: NURSE CALLS:
VA:;UUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE S!GNAL:
INSTRUMENTATION: OTHER:
TOTAL#OF SYSTEM'S;
Owner: Contractor:
KUBIK, THOMAS E + DEBORAH L JET HEATING
14235 SV' FANNO CREEK LP PO BOX 73A'
rIGARD, OR 97224 SALEM, OR 97303
Phone: Phone: 503-363-2334
Reg #• LIC 3P44
FEES Requirod Inspections
Type Ry Daae _ Amc-unt Receipt Low Voltage Inspection
PRMT CTR 9/27/00 $75.00 2720000000 Elect'I Final
5PCT CTR 9/27/00 $6.00 2720000000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 18G 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
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC at (503)
216-1987.
Issued by 1_ ��(.. .C� - Permittee Signature j
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended fob sale. lease, or rent.
OWNER'S SIGNAT URE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SLIPR. ELEC'N - DATE:
LICENSE NO: -- -
Call 639-4175 by 7:00 P M. for an inspection needed the next business day
05/17/00 WED 08:53 FAX 503 598 1960 CITY OF TIGARD 1 003
1
CITY OF TIGARD RESTRICTED ENERGY ELECTRICAL ATION Recd�` by: r
13125 SW HALL BLVD G Date Recd: 9-/x.00
TIGARD OR 97223 PRIiq r OR TYPkN�
V-503-639-4171 X304 ' , , Permit#:
F-503-598-1960 INCOMPLETE OR ILLEGIBLE APV�2�ATIgR* Cust Call'd'
WILL NOT BE ACCEPTEDy _
i� Name of Development ntProject TYPE_AOWORK INVOLVED-RESIDENTIAL ONLY
_.
Rest clad Energy Fee........................................ 80.00
KA6LK (FOR ALL SYSTEMS)
JOB Street Address 31e N -
ADDRESS /y23� S j Check Type of Work Involved:
City/9V, Zip Phone q ❑ Audio and Stereo Systems
Name ❑ S irgiar Alarm
'Ti vm k�t;��z ❑
OWNER M ding Address I�' n Garage Door Opener• `)
c 'Ind CSA 1� L/ Heating,Ventilation and Air Conditioning lam'
C ty/State Zip Phone#
t �' 9 722 f 3 y C] Vacuum systems-
Ne
Jt—I
i'T Q Hyl l_1 Other
CONTRACTOR M ing Agross
'734,2__ 90-?3 1 TYPE OF WORK INVOLVED-COMMERCIAL ONLY
(Prior to issuance a 'Pty/ tate Ip Phone 0 Fee for each system.............................................. 580.00
COP/of all licenses & /3 C' j (SEE OAP.918-260-260)
are required if Oregon Con r. rd I.Ic.0 Exp. ate
expired in C O T. ` t% e L- Check Type of Work Involved:
data base). Electrical Contr.Lic.B Exp. ate
2 7 7 C'�� /C'9c ❑ Audio and Stereo Systems
C O.T or/M)e7roJ is M Exp ate
b I``, 1 ❑ Boiler Controls
Owner's Name
❑ Clock Systems
OWNER - Mailing Address
APPLICANT ❑ ^ata Telecommunication Installation
City/State Zip ❑
Fire Alarm Installation
This permit Is Issued under OAE 918-320.370.This applicant agrees to
make on'y restricted energy installations(100 volt amps or less)under this ❑ HVAC
permit and to do the following.
❑ Instrumentation
1. Only use electrical licensed persons to do installations where required.
Certain residential and other transactions are exempt from licensing. 1__J Intercom ind Paging Systems
These have asterisks(*). All others need licensing;
❑2 Call for inspections when Installation under this permit are ready for Landscape Irrigation Control'
Inspection at 803.639-4175; ❑ Medical
3. Purchase separate permits for all Installations that are not ready for an ❑ Nurse Cells
inspection when the Inspector is out to Inspect under this permit;
4. Assume responsibility for assuring that all corrections required by the ❑ Outdoor Landscape Lighting'
inspector are done,and;
❑ Protective 3igneling
5 Assume responsibility for calling for a final inspection when all of the
corrections are completed ❑ Other
Permits are non-transferable and non-refundable and expire H work is not
started within 110 days of issuance or H work Is suspended for 180 days `Number of Systr ms
The person signing for this permit must be(he applicant or a person No licenses are required Licenses are required to-all other insWarions
authorized to bind the applicant
~FEES: -
LC 4, so �C
Signattlfe—� ENTER FEES
v
8'6 SURCHARGE(.08X TOTAL.ABOVE)
Authority if er than Applicant r' TOTAL1-7
r:ktetstrormsvesC!doc 3198 \ rD0
dv9-
CITY OF TIGARD --- -
MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00384
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 9/27/00
PARCEL: 2S1 12BB-08300
SITE ADDRESS: 14235 SW FANNO CREEK LP
SUBDIVISION: COLONY CREEK ESTATES NO.2 ZONING: R-7
BLOCK: LOT:066 JURISDICTICim: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS.
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
_ FUEL TYPES_ 0 - 3 HP: DOMES. INCIN:
l IG _ 3 - 15 HP COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP:
OD
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS C
OTHER UNITS:
FIJRN -�=100K BTU: <= 10000 cfrn:
GAS OUTLET'S: 1
> 10000 cfm:
Remarks: Replacement of existing furnace with like kind and installation of gas line.
Owner: FEES
KUBIK, THOMAS E + DEBORAH L Type By Date Amount Receipt
14235 SW FANNO CREEK LP PRMT CTR 9/27/00 $72,50 272000000C
TIGARD, OR 97224 5PCT CTR 9/27/00 $5,80 2720000000
Phone:
Total $78.30
'— _—
Contractor:
JET HEATING INC
PO BOX 7362
SALEM, OR 97303 REQUIRED INSPECTIONS
Gas Line Insp
Phone:363-2334 Heating Unt Insp
Reg #:L IC 00003944 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable 1p :,s. All work will be done in accordance with approved
plans. This permit will expire if work is no, .tarted 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 ( 03)246-9189,.
1886e By: L1 C . �i,l_�11/� Permittee Signature: j� �. .�.
Call (503) 539-4175 by 7:00 P.M. for inspections needed the newt business day
05/17/00 WED 08:53 FAX 503 598 1960 CITY O TlG1RD �O 0002
CITY OF TIGARD Mechaliical Permit Applicdq6W'e" �(��� alt: By
13125
13125 SW HALL BLVD. Commercial and Residential S,It.� a �� Date Recd 4-
TIGARD, OR 97223 r;�' 'AS ----
503 639-4171, x304 p'c Dater DS
�� Date tar+G5T�—�
Print or Tpe60� Permit#1lfr9m'n-00
Incomplete or illegible applications will not ba accepted) cased
Name of DevetopmenvProlect Descriptio f
l q 2.3.j SLS � &,k L 1 Table 1A Mechanical Code QWtY Price Amt
I Job Street Addna 9unea A Permit Fee �°. r' der
pr; ' 16.00
Address 1) Furnace M 100,000 BTU
includingducts&vents see footnote 1,2 9.65 �^
BldgM C-'ry�t^tat° Zip 2) Fumace 100,000 BTU+
in-.1luding ducts&vents see footnote 1,2 12.00
Name r name of business) 3) Floor Furnace
Owner ' •`V1rv' " Including vent see footnote 1,2 965
Ma ung Addrou `� 4) Suspended heater,wall heater
235 Su�dCt-v.,� ( or floor mounted heater see footnote 1,2 9.65
h 5 Vent not included In ep lienee permit 475
CltyrState Zip Phar. Check all that apply 'Boiler Heat Air
' ct 7Zz4 g D'`�3N - For Items 6.10,see or Pump Cand Oty Price Amt
Nam"r name of businassl footnotes 1,2 Com
6)<3HP,absorb unit to
_
Occupant Metln100K BTU 9.65pAddrass 7)3-15 HP;absorb unit
100k to 5v0k BTU 17,85
city/Slats zipanone 8) 15-30 HP;absorb
unit.5-1 mil BTU 24.15
Name 9)30-50 HP;absorb
Contractor Zr_ it 1-1,75 mil BTU 3600
J r 14 ufaf T,NG 1G)>50HP;absorb unit
Prior to permit Maain ddro�j n ,/ >1.76 mil BTU 60,15
Issuance,a copy V A� ` 3(o L –��o?" � � / 11 Air handling unit to 10,000 CFM
of all licenses Ci�Btale tip Phan c. _ 7.00
are required If _-� ' CI k3 12)Air handling unit 10,000 CFM+
expired In COT Oregon Const.Cont.Board Lie.lt . . UpJD to 11 86
database 39 YY / 10 C7 13)Non-portable evaporate cooler
Architect am 7,00
14)Vent fan connected to a single duct
Of Mailing Address 4.75
15)Ventilation system not Included in
appliance permit 7.00
Engineer City/Stale Lp Phnne 16)Hood served by mechanical exhaust
_ 7,00
Describe work to be dons: —� 17)Domestic Incinerators
12.00
New O Repair 0 Replace with like kind. Yes�(No 0 18)Commercial or industrial type Incinerator
Residential* Commercial 48.25
19)Repair unha
Additional information description of work: 8.40
n 20)Wood stove/ as Mother units/clothe dryer/etc.
7,00
NOTE: For Commercial projects only;Units over 400 lbs.require 21)Gas piping one to four outlets
structural gas calcs. See footnote 1 3 75 3
Type of fuel: oil O natural gaa k LPG O electric O 22)Mope than 4-per outlet each 75 car
Minimum Permit Fee$60.00 SUBTOTAL
I hereby acknowledge that I have read this application,that the informatior 8%SURCHARGE "';4'Jil95.
-r; c
given in correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTA L' it
II the owmq that pi ns su itted are in ompliance with Oreg n St to laws. Required for ALL commarclal permits only t lar ;4 '
TOTAL ;!
4c)d
Sig- of Owner) gent Date
�1 Other Inspections and Fees:
1. Inspections outside of normal business hours(mininum charge-two
Contact Person Name PhoneI hours) $80.00 per hour
I
2. Inspections for which no fee is specifically Indicated (minimum
charge half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$80.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
Unita. 'State Contractor Soifer Certification required
'— "Residential A/C requires she plan showing placement of unit
1:lmechperm.doc rev 7/19/99