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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Lhie: 639-4175 Business Line: 639-4171 I MST
7
?C, BLIP_Date Requested_ D1� % —AM / PM _ BLD
Location 2-362, I-le,&- Suite MEC 8_
Contact Person — Ph l�� PLM '
� Jf-
Contractor �!"��,ri.r� Ph SWR ¢-
BUILDING Tenant/Owner ELC _—
Retaining Wall ELR _
Footing Access: _—
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: —
Slab _ --- LSC/ �1LG}i."t'i % /C SIT
Post&Beam ---
Ext Sheath/Shear
Int Sheath/Shear
Framing --- ---- --- - -- —
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarin -�
Susp'd Ceiling -------- - - --- ---
Roof
Misc: - -- _
Final --
PASS DART 1-All-
PLUMBING
-AILPLUMBING
Post& Beam ----- ----- - ------
Under Slab
Top Out -____..---- -------- - -
Water Service
Sanitary Sewer _.--
Rain Drains
Final _ _ ___---------- -
PASS PART FAIL
ECHANICA - -
Post& Bearn - --- --- ------------ -- ._._._.. _
Rough In
Gas Line -- - - - -------
S�rnECTRICAL
nS�rnampers
S-3--)PART FAIL - ---- ---
Service
Rough In --
UG/Slab
Low Voltage __—
Fire Alarm _-_.--- --___-
Fina! -
PASS PART FAIL
SITE _
Backfill/Grading ----
Sanitary Sewer
Storm Drain [ Reinspection fee of$__- --__required before next inspection. Pay at City Hall, 13120 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for rear 3pection RF _ —FT [ ]Unable to Inspect no access
ADA
Approach/Sidewalk Date -3/ 1 C Inspector �' y� Ext
Other _L_�__��. __-- p - __- —_-.-- ----
Final _
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY O TIGARD MECHANICAL
PERMIT
DEVELOPMENT SERVICES i 'ERMi"r #. . . . . . . : MEC99-009-1
1.3125 SW Hall Blvd., Tigard,OR 97223(503)639.4171 DATE ISSUED: 03/04159
PARCEL: 2S102DB-01700
(SITE ADDRESS. . . : 09300 SW HILL.. ST
SUBDIVISION. . . . : BURNHAM PARK ZONING,: R-4. 5
BI-OCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :011 JURISDICTION; TIG
CLASS- OF-WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE 0= USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
GCCUPANCY GRP. . :R3 VENTS W/O AP'PL.: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . .. 0 BOILERS/COMP'RESSQRS 140ODS. . . . . . . : 0
FUEL T YP'ES-_.___._-_-___- 0 HP. . . . : 0 DOMES. I NC I N: 0
3-1 5 HP. . . . : 0 COMML. I NC I N: 0
MAY T.NPU'T: 0 BTU 15--30 HP'. . . . . 0 REPAIR UNITS. 0
c7 1 RE' DAMPERS?— .30-50 HP. . . . - 2 WOODSTOVE S. . : 1
GAS PRESSURE. . . : 50+ HP'. . . . : 0 CLO DRYERS. . : 0
NO. OF L'NITS--- ----- AIR HANDLING UNI-'S OTHER UNITS. . 0
F'JRN ( 100K BTU: 0 (=- 10000 cffii : 0 GA! OUTLErE3. : 0
FLIRN ) -100K BTU: N ) 10000 cfm : 0
Remarks : Install a wood stove fireplace insert.
PAUL- JOHNSON type amoLi:,r by date recpt
9300 SW HILL. ST P RMT $ 25. 00 GF-O 03/04/99 99-213449
T I GgRD OR 9-1224 5PCT E 1. 25 GEO 03/04/99 99-3t.3449
Phone #: 620-2923
Contractor-: ---- - -- ------ ----------------
OWNER
L 26. 25 TOTAL
Phnne #:
Reg #. .
REQUIRED INSPECTIONS -•_____.__ _
This permit is Issued subject to the regulations containri in the w a„d s t o Y e I n s p
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
with,.n iR days of issuance, or if work is suspended for torp
than IPA days. ATTD;TIf)N: Oregon law requires you to follow rules
adopted by the Oregm Utility Notifiratioii Lenter. Those rules are
set forth in UAR WP-001-9010 throagh OAR 952--@01-0800. You may --
obtain copies of these rules or direct questions to OLK by calling
(503)246-9107.
i
P'ei,mii.tee 5ignatmr-e
i
+++++++++++++++++i +++++++++++++++++++++++++++++++++++++++F++++++++++++++.M++++-4+
Call 639-4175 by 7:00 p. m. fnr- inspections needed the next bLfsines�, day
++++++++++++++++++++++f•+++++++•f-+4++++++++++++++++++++++++++4•+++++4+4+4-+++++4+++
CITY OF: TIGARD Mechanical Permit Application Plan Check# _
PP Recd By __
13125 S,fV HALL BLVD. Commercial arid Residential Date Recd__ _
TIGARD, OR 97223 Date to N.E.
(503) 639-4171, x304 Date to DST__
Print Or Type Permit#>Tl
Incomplete or illegible applications will not be accepted Called —
Name of Development/Project UBSC:IptlOn
i� _ Table 1A Mechanical Code Ot Price Amt
Job A) Permit Fee
Street Address Sufle# _
<.I ^ ) �) / 7//J 1) Furnace to 100,000 BTU 10 00
Andress _l'G�l. _S,✓L S includes ducts&vents see footnote 1,2 6.00
Bldg# Cd)/Sols Zip 2) Furnace 100,000 BTU+ —
/-ro /4/0 ? 0,—Z including ducts&bentssee footnote 1,2 7.50
Name(or name of business) 3) Floor Furnace --
Owner C" /},j)43 — including vent see footnote 1,2. 6.00
Mailing Address `— 4) Suspended hee ter,wail heater
of floor mounted heater _ see footnote 1,2 6.00
__ 5) Vent not included in appliance permit
CflylStete �+ ZipPhones 3.00 �
Chack all that apply, 'Boiler Heat T Air
Name(or name of bushess) For Items 6-10,see or Pump Cond Qty Price Amt
footnotes 1,2 Comp ••
Occupant Mailing Address 100K BTUbsorb unit to
_ 6.00
7)3-15 HP,aba,rb unit
Chy/State Zip Phone 100k to 5001r B-U 11.00
— B) 15-,,HP;aL;orb
Crintractor Name unit.5-1 mil BTU 1500
9)30-50 HP:absorb
unit 1-1 75 mil BTU _ 22.50
Prior to permit Mailing Address 10)>50HP'absorb unit
issuance,a copy _ _ >1.75 mil BTU
of all licenses City/State —ZT{ Phone 37.,0
—� 11)Air handling unit to 10,000 GFM
are required if __ 4.50 _
expired in COT Oregon Const Cont Board Lk:llExo Uale 12)Air handling unit 10,0(,0 CFM+
database_ _- _ _ _ 7.50 _
Architect Name 13)Non-portable evaporate cooler
4.50
or
Mailing Address —V 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)Hord:served by mechanic aI exhcust—
Describe work to be:done —4.50
17)Domeb'ic incinerators
New 0 Repair O Re,lace with like kind Yes O No O _ _ _ _ _ 7.50 _
Residential,O Commercial U 1d)Commercial or industrial type Incinerator
30.00
Additionalinformationor description of work. � 19)Repair units —
t�(� 20)Wood stove --.�.� y� 450
NOTE: For Commercial projects only,L,,.''a over 400 Ibs reauire _ 4 50
strudurall _S Celts`_ 21)Clothes dryer,etc�—
Type of fuel oil O natural gas O LPG O electric O
___ 22)Other units
I hereby e '-towledge that I have read this application,that the information _— _ 4.50
given is^.uv'r3 that I am the owner or authorized agent of 23)Gas piping one to four outlets
the owner,that plans submitted are in compliance with Oregon State laws See footnote 1 J2O
24)More than n.-per outlet(each) J_,
si of Ovim I ant ,: Date
Minimum Perrnit Fee$25.00 SUBTJ IAL
Contact Persort a Phon — ----'
�-� ___ __ 5%SURCHARGE
_fie _ PLAN REVIEW 25%OF SUBTAonI
Foonotss for commercial projects only: _ Required fo,A_L_L commercial permit1 Provio>full schematic of existing and proposed gas line and pressure T
2 Provide drawings!o scale showing existing and proposed mechanical
units _ _ _—_ 'Slate Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I Vmechperm doc rev 02/4/99
CITY OF TIGARD
DEVELOPMENT SERVICES
13125 SW tial'Blvd., Tigard,OR 97223 (503)639.4171
I
I
���� C
CITY OF TIGARD Plumbing Application R.ec'd By
Dale Recd -
131 Y5 SW HALL BLVD. Commercial and Residential Datp to P E.
TIGARD, OR 97223 Date to DS
(503) 639-4171 Permit#'tty 7-0
Print o. Type Related SWR#
Incomplete or illegible appFcations will not be accepted Called _
Name of DevlopmenUproject ;« Mew Slnale FatMily Residences OnlvX:'2,AA
Job aT1 TtI NO SF 5140.00 s19br•'.i
Address Street Address oui19 c xF '• � f~*T+ryc-[7' N.,, f ..
,.,•r.,.•;eii�'� ��v OK3 BATH tiOUSE�22500 �',i5,'�1�4► t�
' (.,, ` , � � t� � ,.�t � _ _ 'Foe lnctudes all'p�urntiing fixtures 7n the dwelltttp�ncj the rst 100 feet of �'r .«,�
Bldg# City/State Zip water service,sanitary sewer and storm sewer .See fees below. iit'.�./
- Name FIXTURES(Individual) QTY PRICE AMT
Sink 9.00
Owner `Mailing Address Su',e Lavatory 9.00
U L' ►�) I
'itS
Tub or Tub/Shower Comb. 9.00
Ilate Z' Phone
( `C� Z Shower Only 9.00
Na Water Closet 9,00
Dishwater 9.00
OCCUpa!lt Marling Ad re5s -j Suite - Garbage Disposal - - 9.00 --
_ Washing Machine 900
City/State Zip Phone Floor Drain v 2 9.00
---------- Name - 9.00
4' - 9.00
Contractor Mailing Addrass Suite'- 'Nate,Heater 9.00
j I2t, ,(t 1/, do Laundry Room Tray 9.00
CIty1Slal Zip Phone - -
Unnal 9.00
� Iii ( � 1. �-- r I_�• I �. �. -- -
Oregon Const.Cont. Board Lic.# Exp.Dale Other Fixtures(Specify) 9.00
Attach Cozy f i i - � _ -- 9.00
Current Plumbing Lic.0 Exp.Date - - 9.00
License -1 --, e". ----
Sewer-1 sl 10U" 9.00
COT Business Tax or Metro# Exp.Date Sewer-each additional 10U' 30.00
Name Water Service• 1st 100' i 25.00 �
Water Service•each additional 200 30.00
Architect Mailing Address Suite - Storm&Rain Drain-1st 100' - 25.00
Or
Storm&Rain Drain-each additional 100' 30.00
-_
City/State locate Zi - Mobile Home Space 25.00
Engineer y" p Phone
Commercial Bark Flow Prevention Device or Anti- 25.00
Describe work New O Adcition O Alteration O Repair Pollution Device
to be done: Residential O Nonresidential O Residential Backflow Prevention Device' 15.00
Additional description of work - Any Trap or Waste Not Connected to a Fixture - 9.00
Catch Basin 7 )0
t Insp.of Existing Plumbing 4'1 00
Existing use ofpe, hr
Specially Requested Inspections 4C.00
building or property _ per hr
Rain Drain,single`amlly dwelling 30.('.0
Proposed use of --- _- ___ --
tuilding or property-- _ G. ase 1 raps 9.00
- _ QUANTITY TOTAL �,;[L`�"�liiaty�
Are you capping -�3n fixtures' Yes C] No p �
-- -- - Isometric or nser diagram is required if Ouanity Total is >9 T ,Mi,
I hereby acknowledge that I have read this application,that the information
given is correct.that I lam *.9UBTOTALthe owner or authorized agent of rhe owner,and `�.
that plans suamihed are in compliance with Oregon State laws. _ _ ----- 5% SURCHARGE r�% _,..
Signature of Owner/Agent Date J �?.
PLAN REVIEW 6%OF SUBTOTAL
•` - --- Required only if fixture qty total is>_9
Cont9ct Person Name Phone - TOTAL
'Mlnlmum permit fee is 525- 5%surcharye,except Residential Backflow
i td<_tstplmapp.doc
Prevention Device,which is$15+ 5%surcharge