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10700 SW HIGHLAND DRIVE ' I � r � 0 ! o cr E S H S r Z 4 0 U S H C M w AI21Q QNt1']HO1H MS OOLOT CITY CSF TIGARD DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard.OR 97223 (503)6?9.4171 pu". I ISSUE ISS I rIPST, OF wo ....... 0 or USE, FLOOR LO-Alli— t SECTID... sf ,T I'Y CONS-, MLLING LINITS: 0 GRP, 'R" rINBSKENT- BDRV,; 0 BOTH. 0 ",ITqL---- '90e, Y ----------- ZLUWM� ""W" ^j*-'dR LIME ft: 7, 7 111,111k, DRPI: "-�L 5F OR LESS: 0 "lot asp— 0 alp, W,LVC OF FDR., 0 T ID01 L 'kW. "L01 40? amp..; L11 44 amp.. 0 1;t W!C SITIFM 0 IN : I r171 0.1 it tw. r 7'4! 772 COL"I'W,- C?1 Z W1 f'& alp, LINA' Vic Z ASX!rDri; 2 5o I Im, amp,; Y114r, asph0t.: t Ir- RF-5nnert on,'j. e )74 qEt, WTI. "'V' P) 1" 'Lr'.71 74, Ort 31RI CTr,, r, 'MIUM "YSTM f-'Vo t S7041T' FI'}r ALP ' 7, HVDV........... 'ADSC.7 71 'CIS" 7L"-sart' i7ol5 SE 01D DF Tigvdl Mrcipai rcdp, Stale lre. Spec-1:. I4P 011 P, licab'e laws' Ala p.4, w. hitt, approved "i s prr c start-1 181 day t. s,�spenilvd fir sore Vas W dais. ^H"WIT4. req"ilet yc_.: t'. rt'11-'w at"5ptv' t.r tr'e ""r t C3 1*c'-PC-?t19' yf"'i Nq r'ttilil Of k�, CITY OF TIGARD �o�,xnereial Building Permit � Read By 13'05 SW HKL.L BLVD, New Construction and Additions Date Recd_ Date to P.E. TIGAFi^, OP, 87223 Date to DST (503) 639-4171 Permit x +tit 5 T ./ (iL 3U Print or Type ( Relalad SWR ar Incomplete or illegible applications will not be accepted Called_ Name of DevelopmenUProied — EXISt'ng Building [] New Budding [] — Job � ' Address StreetA�dress f/ Suite Buildino Data Bldg 0 Cityrstatd Zip Existing Use of Building or Property: ____ _ Proposed Use of Building or Property: Property Owner Mailing Address, Suite I 3 &"'/ No. Of Stories: City/State Zip Phone -- r` �?122-1 Sq. Ft. Of Prated —— Occupant Name — &'f,��J Occupancy Classes) —J Name ,� Contract . i —e- L tgi/) _ Type(s) of Construction Prior to permit Mailing Address Suite issuance. a copy , , ,=;J ___- Will this project have a Fire Suppression System? of all i enses (�L x Yes No are raqulred if CltylState zip Phone expired m C.O.'rAmericans with Disabilities Act(ADA) . ., darabasn �T!' /Cwl . / tZ �L� Valuation X 25% = $ Participation Oregon //Const.Cont.Board Lic.rf Exp.Date Complete Accessibility Form fJG�C7 �j 1'' Project— $ NE1,; - � Valuation � y Architect ��" _Mg Addie s quite - PIanS Required See Matrix for number of sets to submit on back - Tl cityiStato Zip Phone A I hereby acknowledge that I have read this application,that the information Name given is correct,that I am the owner or authorized agent of the owner, and Engineer that plans submitted are in compliance with Oregon State Laws N _ _ Meiling Addresr Su.te Si a of Own gent Date :iiyrsr(� Zlp Phone on art Person Name Phone Indicate type of work. NewX1 Addition O Demolition o FOR OFFICE USE ONLY Accessory Structure O Foundation Only O Alteration O - -- -- -- _ Pepair O Other O Map/TL# Lend Untie: Description of work✓j` �jQ,G ------ -- 1 '0 r#1 Ti war /Jl - Notes koke.4stimated /7 TIF>e of Employees Note: Site Work Permit Application must precede or accompany Building Permit Application I\Cc7MNEW DOC (DST) 8197 COMMERCIAL, PLAN SUBMITTAL REQUIREMENT MATRIX DISTRIBUTION TO PLANS OUT TO DST _EXAMINERS _ (Note a.) 'LYPE OF SUBMITTAL 'TOTAL CPL". EP FPF— CPE PPE EPE . SITE 3 (j,o,u) -- -- 13 (New or Add) I 1 -- - 3 O,o,w) -- -- F (Ncw or Add or Alt.) 3 - - 3 O,o,f) M (New or Add. or Alt) 1 1 - -- 20,o) -- _ B &. M (New or Add) 1 I - -- 3 O,o,w) -- -- P (New, Add. or Alt) -- -- 20,o) -- B & M & P (New or Add.) 2l -- 3 (j,o,w) 2(j,o) -- E (New, Add, or Alt) - -- 2 -- -- 2(j.o) B & M & P & E (New, Add) 3 1 1 1 3 (j.o.%%,; 2(j,o) 2 (0) B or B & M (Alt) l l -- -- 2. 0,o) -- 13 & M & P (Alt) 3 1 2 -- 20.0) 2 (0" -- B & Nt &. P& E (Alt) 3 1 1 1 2 (i,o) 2 (j,o) 2 (j,o) yi 01 ES: K(Y: a. Before returning to DST, Plans examiner gets appropriate j =Job B = BUP number of revised plans from applicant, stamps and completes, o = Office M = MEC updates and adds actions. f= hire P = PLM u = USA E= ELC h. Shaded areas designate AL'I' suhrnittals oily, w= Wash. County F = FPS r. FPS is a new permit category set a:ide for fire sprinklers and fire alarms. d. Effective August 15, 1997,Tualatin Valley Fire and Rescue no longer requires a set of approved plans to be forwarded to their office. L•xception. continue to forward a copy of approved fire sprinkler and fire alarm plans with calculations. h Vnatdc.Da; CITY OF TIGARD - DEVELOPMENT SERVICES PLUMBINGT #. . . . PERMIT PERMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSSUED:UED: 10/13/97 100F�LM'37-041 /13/97 PARCEL.: 2S 1 l ODD-1200 SITE ADDRESS. . . : 10700 SW HIGHLAND DR SUBDIVISION. , . . : SUMMERF I EI_D N0. 13 ZONING: R-7 BLOCK. . . . . . . . . . . L0T. . . . . . . . . . . . . :692 JURISDICTION: TIG ---------------------------------------------------------------------------------- CLPSS OF 6!ORK. . :ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0 TYPE OF USE. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . :R3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . : 0 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 1 CATCH BASINS. . . . . . . : 0 FIXTURES--------------- LAUNDRY TRAYS. . . . . : 0 SF RAIN DRAINS. . . . . : 0 SIN:(5. . . . . . . . . . 0 URINALS. . . . . . . . . . . . QZ GREASE TRAPS. . . . . . . . 0 LAVATORIES. . . . : 0 OTHER FIXTURES. . . . : 0 TUB/SHOWERS. . . : 0 SEWER LINE (ft ) . . . : 0 WATER CLOSETS. : 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . : 0. RAIN DRAIN (ft ) . . . : 12N "remarks : Install a new hot water heater fer an existing single family dwelliiiy. Owner: —________________.__.___—______-----_____.__________.___—.- FEES GENE RAINES type amor.int by date recpt 10700 SW HIGHLAND DRIVE PRMT f 25. 00 GEO 10/13/97 97-299980 TIGARD OR 97224 SPCT $ 1. 25 GEO 10/13/97 97-299988 Phone #: 624-7030 MP PLUMBING CO MILWAUKIE PLUMBING CO PO BOX 39 CLACKAMAS OR 97015 ___--------.----_...-------------------- ~ Phone #: 65b--9161 $ 26. 25 TOTAL_ Reg #. . : 000050 - ----- REQUIRED INSPECT*ONS - - -This permit is issued subject to the regulations contained in the Mi sc. Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection applicable laws. All work will be done in accr.-dance with approved plans. This perait 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 by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 thrnugh OAR 952-0001•-08R0. You may obtain copies of these rules or direct questions to tt4C by calling (503)246-'987, 12 n Iss1.red R 4f4 Permittee Signatr.tre: +++++4-++i-.++-F+++++++++++4'Ft+++++++++++++++.-F. ...++'+++++++++++++-f++++1'-h++++++++ Call 639-4175 by 7:00 p. m. for an inspection needed the next br.isinescs day +++++++++++i•+++++++++•+++++.1+++++i-+++++++++++�.++++++++++++++++++++++++++++++++•+ !:FY OF TIGARD Plumbing Application Recd By._ 1%6 �W HALL P,i.VD. Commercial and Residential Date Recd_ Date to P E —_ I rGARD, OR 97223 Date to DST ;03) 6°,9-4171 Permit til Print or Type Reialed SWR s Incomplete or illegible applications will not be accepted Called__-- _ Name of DevelopmenUPr lett FIXTURES (individual, - QTY PRICE AMT Job Sink 9 OP Address Street Address Suite Lavatory - 900 ' Tub or Tub/Shower Comb 900 Bldg k Cif JState /Zip Shower On,y 900 ----_-.--- .0 Cl f orvv��cl.) Water Closet 9 00 Name - - — (�i�(`I. _ Dishwater — _ --_ - 9 00 Owner Mailing Address Suite arbage Disposal 900 /'-AL/t' Washing Machine — 900 Cdy/State Zip Ph( 01 — Flor•drain 2' - _----� 9 00 3' 900 Name 4' 900_ Occupant Mailing Address Suite Water Heater 960 Laundry Room Tray 900 City/State — Zip Phone Unnal 900 - ---- — Other Fixtures(Specify) Name 9.00 Contractor Mailing Address ne 9.00 .It;/State Zip Phone — 900 i Oregon Const.Cont Board Lic.9 Exp,Date 900 ..ttach Copy of i y ('y 9.00 Current Plumbing L, 0 _r _� Exp Date Sewer- 1st 100' 30 00 i.!'.onses t t_) Sewer-each additional 100' 25.00 - - - COT lusiness Tar or Metro>r Exp.Date -� ( Water Service- 1st 100' 30.00 � Name Water Service-each additional 200' 25.00 Architect Storm&Rain Drain- 1st 100, — 30.ul or M•ading Address Suite Storm&Ram Drain-each adc tional 100' 25.06 Mobile Home Spare 25.00 Engineer City/State Zip Phone Commercial Back Flow Prevention Device or Anti- 25.00 pukulion De vice _ ascribe work New O Addition O Alteration O Repair it Residential Backflow Prevention Device` 15.00 be done: Residential 0 Non-residential O Any Trap or Waste Not Connected to a Fixture 9.00 tditional description of work Catch Basin 9.00 Insp.of Existing Plumbing 40.00 er/hr Specially Requested Inspections 4000'lse of perRtr tiding or H:uperty_ Rain Drain,single family dwelling 3000 _ )posed use of Grease Traps -----7T0-0 Iding or property _ QUANTITY TOTAL. e you capping. moving or replacing any fixtures? Yes p No p Isometric c,neer diograni is reou_uea d ouanxy Total is ,9 s see _back Y_eback of form _ —_--- — ! 'SUBTOTAL 1 ereby acknowledge that I have read this application,that the information en is correct,that I am the owner or authorized agent cf the owner,and 6%SURCHARGE it plans submitted are in compliance with Oregon State Laws .nature of Owner/Agent Date -PLAN REVIEW 25%OF SUBTOTAL _ Aeouired only A fixture ory total it>9 _ TOTAL i --- Intact Person Name Phone I \ 'Minimum permit feea$23 5%surcharge.except Residential Backflow — Prevention Device,which is S 15 5%surcharge I:Wststplmapp doc 8/96 PLEASCOMP .FTE AS_ APP-R4RSIAZE-I4PROJECT: _Fixtures to be capped, moved or replaced Qty Sink _ Lavatory __—~ _ Tub or Tub/Shower Combination _ Shower Only Water Closet Dishwasher Garbage Disposal Washing Machine------ Floor Drain _ 2 _ Water Heater Laundry Rool i Tray _ Urinal Other Fixtures (Specify) ---- -- — --- --- RECEIVED 1991 ---- -___ -- -- -- - - -- - - CU ;illy UEVELUFMENI COMMENT'S REGAi?DING ABOVE: CITY OF TIGARD BUILDING INSPECTION DIVISION � MST 2A Hour Inspt ction Line: 639-4175 Business Line: 639-4171 -- ---- -- n BLIP _ ate Requ ,sted__. AM ---PM - -- BLD ---- — Location_ l-�Q Suite MEC _ Contact Person i — —_ r Ph _T�-- PLM T7- i-ontractor Ph SWR BUILDINGTenant/Owner ELC Retaining Wall ---- EL.R _ ✓� Footing Access: Foundation FPS Fig nrain SGKI ,ravel Drain Inspect on Notes --Slab ---- SIT Post 8 Beam ._� �—_-------- --_-__-__-- Ext Sheath/Shear _ :nt Sheath/Shear - Framing Insulation - —`-�-- --- - --- Drywall Nailing Firewall Fire Sprinkler --__.._._ ___ _ - Fire Alarm Susp'd Ceiling -- --- -- ---- - - Roof Misc._ -- Final - P _ T FAIL _ (gLU.NJ6 F'ost&Beam - - --- - - Under Slah Top Out - Water Service rani.!ary;ewer - ., 1s P.ASSART FAIL _—_ MECHANICAL Post& Beam ---- Rough In Gas Line Smoke Dampers Final — PASS PART FAIL ELECTRICAL - -- --__ - Service Rough In UG/Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE _�-- �.. Backfill/Giad;ng Sanitary Sewer Storrn Drain ( j Reinspe^lion fee of$ required before next inspectru0 Pay at City Hall, 1312E SW Hall Blva Catch Basin Fire Supply line ( ]Please cellfor reinspection RE -_---___ [ J Unable to inspect-no access ADA Approach/Sidewalkate 61- D , Inspector Other - Final PASS PART FAIL 00 NOT REMOVE this inspection record from the job site. CITYOF TIGARD _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: PLM1999-00369 A 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: SITE ADDRESS: 10700 SW HIGHLAND DR PARCEL: 2S110DD-12200 SUBDIVISION: SUMMERFIELD NO.13 ZONING: R-7 BLOCK: LOT: 692 _ JURISDICTION: TIG CLASS OF WORK: ALT GARBAGE DISPOSALS: MOBILE HOME SPACES _ TYPE OF USE: SF WASHING MACH, BACKFLOW PREVNTRS: 1 OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE. TRAPS: LAVATORIES: OTHER FIXTURES: TUB/SHOWERS: SEWER LINE: ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: ft Remarks: Install residential backflow prevention device. _Owner: FEES RANES, FRANCIS E Type By _ Date V Amount Receipt 10700 SW HIGHLAND DR PRMT KJP '1/05/199 $25.00 99-319595 TIGARD, OR 97224 5PCT KJP 11/05/199� $2.00 99-319595 Total $27.00 Phone 1: --i Contractor: MODERN PLUMBING 1112.0 SW INDUSTRIAL WAY TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone 1: 691-6166 RP/Backflow Preventer Peg #: LIC 87906 Final Inspection PLM 34-250PB EXPIRFn ORIGINAL 111el This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable iavvs. All work will be done in accordance with approved pians This permit will expire if work is not started within 180 days of issuance, or if work is suspended for mor:)' than 180 days ATTENTION: Oregon law requires you to follow rules adop,ed by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080 You may obtain copies of ',hese rules o, airect questions to OUNC by caping (503) 246-1987. iss(ied By: Permittee -S;-nature: " Call (503) 639-4175 by 7:00 P.M. for un inspection needed the ne t business day CITY OF TIGARD Plumbing Permit Application Plan Check#_ 13125 SW HALL_ BLVD. Commercial and Residential Recd By _ Date Recd t _ TIGARD, OR 91223 (50a) 639-4171 Date to P E. �) I Date to DST Print or Type Permit# ) �j na — T_( 3k,� Incomplete or illegible applications will not be accepted Related SWR# Name of Development/Project — FIXTURES (individual) __ ` _ QTY PRICE AMT Sink 9 00 Job _ --- —��- 9.00 Address Street Address Nl y Lnti1 Suite Lavatory _ C� ��j � yn Tub or Tub/Shower Comb 900 Bldg# 1 CItylstate Zip Shower Only 9,00 I Q rZ 9 7 Z.Z Water Closet 9.00 - - — Name9 00 E )7NE 5 Dishwasher Owner Mailing Address N, h��L�Al Suite Garbage Disposal 9 00 lC'�G4 5,t✓• J�ISL-- Washing Machine _ 9.00 City/State �Zip Phone Floor Drain/Floor Slnk 2" 9.00 ��, /C v/[C• rD -70 6 900 3" _ Na 4" 9.00 } Mailing Address Suite Water Healer O conversion O like kind 9.00 Occupant Gas piping re tyres a separate mechanical permit. City/State Zip Phone Laundry Room Tray 9.00 Urinal 9.00 f- -- #7N1 Other Fixtures(Specify) .00 00Contractor Sulle 00 Print to permit ip Ph a Sewer-1st 100' 30.00 issuance,P Copy d l &z Sewer-each additional 100' 25.00 of all IicensAs are Oregot.Board Lic.# Exp.Date O Water Service-1st 100' 30.00 required if c t Exp.Dater Water Service-each additional 700' 25.00 expired in CUT umbing Llr, C d -- p Storm R Raln Drain-1st 100' 30.00 database _ Na a Storm R Rain Drain-each additional 100' 25.00 Architect Mobile Home Space 25.00 Or Mailing Address Suite Commercial Back Flow Prevention Deice or Anti- 25.00 Pollution Device _ City/Stale Anti- ZIP— Phone Residential Backflow Prevention Device' 15.00 Engineer (Irrigation tim.ng devices require a separate restricted ei a permit.) Describe work to be done: or Waste Not Connected to a Fixture 9,00 Any Trap New O Repair O Replace with like kind: Yes O No O Residential O Commercial 0 Catch Basin Additional description of work: r�� Insp.01 Existing Plumbing -- 40.00 �ermr EXPIRED Specially Requested Inupections 4000 �er/hr ti,—InDrain,single family dwelling 30.00 Are you capping,moving or replacing any fixtures? Grease Traps 9.00 Yes O No O _ If yes,see back of form to indicate work performed by QUANTITY TOTAi- fixture. FAILURE TO ACCURATELY REPORT FIXTURE Isometric orrlserdiagram Isrequtred0QusnMyTotal is >9 -- WORK COULD RESULT IN INCREASED SEWER FEES. SUBTOTAL�^-I 1 hereby acknowledge that I have read ihls application,that the Information - %SURCHARGE n given Is correct,that I am the owner or authorized agent of the owner,and G that plans submitted are in compliance with Ore on State Laws. Signature/ Ow Agent f' Dato **PLAN REVIEW 25%OF SUBTOTAL / Required onj H future qty tote)is+9 �� // TOTAL 6 Co Phone L7'7 'Mlnlmum permit tee is$25+5%surcharge,except Residential 3ack0ow _ T 7 4 / Prevention[)Pvice,which is$15+ 5%surcharge -All Now Commercial Buildings require plans with isometric or riser diagram and plan review t wstslptumspp dor 78199 PLEASE COMPLETE: Fixture Type Quantity by Work Performed __ _ New Moved Replaced Removed/Capped Sink --- Lavatory _ _ _Tub or T_ub/Shower Combination —. --__ ----- Shower Only --- -- — — -- ------ —------ __— Water Closet Dishwasher Garbage Disposal Washing Machine_--_. Floor Drain/Floor Sink 2" — �_ -- -- 4„ Water Heater --- LaundryRoom Tray - _Urinal Other _ -------- — — - I - -----..____ _— Other Fixtures (Specify) --- __- - —� COMMENTS REGARDIr!G ABOVE: t A t riu—e j.d,, .nn CHANICAL CITY OF TIGARD MEPERMIT DEVELOPMENT SERVICES PERMIT #. . . . . . . : MEC98-0480 13125 SW Hall Blvd., Tigard,OR 97223(503)639.4171 DATE ISSUED: 10/28/98 PARCEL: 2S110DD-12'200 SITE ADDRESS. . . : 10700 SW HIGHLAND DR SUBDIVISION. . . . : SUMMERFIELD NO. 13 ZONING: R-7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :69` JURISDICTION: TIG CLASS (IF WORK. . -ALT FLOOR FL)RN. . . . : 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES----------- 0—:3 HP. . . . : 0 DOMES. INCIN: 0 -GAS 3-15 HP. . . . - 0 COMML. INCIN: 0 MAX INPUT: 4 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS''. . : 30-50 HF'. . . . : 0 WOODSTOVES. . .- 0 GAS PRESSURE. . . : 50+ HP. . . . -. 0 CLO DRYERS. . : 0 NO. OF UNITS-----------_. AIR HANDLING UNITS OTHER UNITS. s 0 FURN ( 100K erti. o l= 10000 cfm: 0 GAS OUTLETS. : I FURN ) =100K BTI J: 0 > 10000 cfm: 0 Remarks : Ranes Owner: FEES GENE RANES type aMOIAnt by date recpt 10700 SW HIGHLAND DRIVE PRMT $ 25. 00 JSD 10/28/98 9S-310367 TIGARD OR 97224 51PCT $ 1. 25 JCD 10/28/98 98-310367 Phone #.- 624-7030 VOID Contractor: COLUMBIA HEATING & COOLING INC PO PJ,( 230397 $ 26. 257 TOTAL. TIGARD OR 97223 Phone #: 624-2704 Reg #. . : 000763 REQUIRED INSPECTIONS This permit is issued subject to the ragula'iDns contained io the Mechanical Insp Tigard Municipal Code, State of DrF. Sperialt-, Codes and all other Final Inspection applicable laws. All "nrl. will hr done in accordance with Approved plans. This permit will *xpire if work is not started within 180 days of issuance, or if work is suspende i for more than 180 days. ATTFNTION: Oregon 1-w requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in Opr 52-001-001@ through DAR 952-001-8880. You may obtain copies or .hese rules or direct questions to OUNC by calling (503)246-9187. _7^ / _ __.___ __ __ 2 __. Permittee Signatt. Issue Ire ++4.............4-4.++4-4-++4...............................................4+4.+ ff-4 Call 639-4175 by 7:00 p. m. for inspections needed the next business day ......................4-+++4................4•.................................1-+++ CITY OF TIGArD Mechanical Permit A )plication Plan Check# — p Recd By 13125 SW HALL BLVD. Commercial and Residential Date Recd TIGARD, OR 97223 Cate to P.E. (50?) 639-4171, x304 Date to DST Print or Type Permit 0 rn c C ' 6 Incomplete or illegible applications will not be accepted called n _ Na a ofDevelop ro)ed U@SCfIptlOn Table 1A Mechanical Code Qt Price Amt Job Street Address Sune# A Permit Fee 1000 AddressQ 1) Furnace to 100,000 BTU including ducts$vents _ 6.00 Bldg# CRY/State Zin 2) Furnace 100,000 BTU+ including ducts&vents 7.5U Ngme(or name of By 3) Floor Furnace Ownerincluding vent 600 Mailing Address / �S __ --- 4) Suspended heater,wall heater or floor mounted heater _ 600 CL,� CGU / 16 LJ " 5) Vint not included in appliance permit -C�ft'y/'State LGA-, Phone 3.00 CHECK ALL *Boiler Heat Air Nam (or name of bL THAT APPLY. or Pump Cond Qty Price Amt n Com •• Occupant Mailing Address 600K BTUbsarb unit to 6.00 7)3-15 HP;absorb unit Cny/State �zip Phone 100k to 500k BTU 11.00� 8) 15-30 HP;absorb Contractor Na - _ unit.5-1 mil B)U 15.00 9)30-50 HP;absorb du/)I ! unit 1-1.75 mil BTU _ 22.50 Prior to permit Ma(ling Ad"s �� 1 p)>50HP;absorb unit issuance,a copy Ln `� = `1 >1.75 mil BTU 37.50 of all licenses Cy/state Zip Phone 11)Air handling unit to 10,000 CFM are required If L r 1J �,V 4.50 expired in COT Oregon Const Cont.Board Llo.# Exp Cate 12)Air handling unit 10,000 CFM+ _ database -2-c 7.50 Archriect Name 13)Non-portable evaporate cooler 4.50 ot• Mailing Address F W 14)Vent fan connected to a single duct 3.00 _ 15)Ventilation system not included in Engineer CRY/State Zip Phone appliance permit _ 4.50 16)Hood served by mechanical exhaust Describe work to be done. _ _ 4.50 17)Domestic Incinerators New O Repair O Replace with like kind: Yes O No 0 _ 7.50 Residentlal)-- Commercial O 18)Commercial or industrial type incinerator 30 f7i Additional information or description of 11 ork: L 19)Repair units 1111(4 !U T(��'��C� LC1 r �rl 4 50 20)Wood stove (1 1'7 4.50 f1� 1 5 )A 1 0) ?`_ 21)Clothes dryer,etc. 4,50 Type of fuer oil O natural gala LNG 0 electric O 22)Other units 4.50 1 hereby acknowl%jge that I have read this application,that the information 23)Gas piping one to four outlets given is correct,that i am the owner or authorized agent of _ 2.00 the owner,that plans submitted are in compliance with Oregon State laws 2.4)More than 4-per outlet(each) .50 Signature Owner/A nt Date Minimum Permit Fee$25.00 SUBTOTAL 5/a SURCHARGE Canted Pofson Nam Phone PLAN REVIEW 25%OF SUBTOTAL Required for ALL commercial perrnits only_ TOTAL i 'State Contractor Boiler Certification required "Residential A/C requires site plan shu:rng placerm nt of unit 11me:hperm doc rev 07/20/98