16690 SW MATADOR LANE sueI J0pegeW MS 0699E
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16690 SW MATADOR LN
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT N: MEC2001.00238
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 DATE ISSUED: 6/27/01
PARCEL: 2S 116AD-08300
SITE ADDRESS: 16690 SW MATADOR LN
SUBDIVISION: KING CITY NO. 12 ZONING:
BLOCK: 18 LOT:015 JURISDICTION: KIN
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: 2
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50+ HP: CLO DRYERS:
FURN < 100K BTU: 1 _ AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of new gas furnace, associated venting fur furnace and Inas water heater and gas work.
Owner: v_ FEES
BOYD, DORIS M Type By Date Amount Receipt
16690 SW MATADOR LN PRMT BLD 6/27/01 $72.50 KING CITY
TIGARD, OR 97224 5PCT BLD 6/27/01 $5.80 KING CITY
Phone:
Total $78.30
Contractor:
BELL HEATING
(GREG MILLETT)
15160 SE PIAZZA AVE REQUIRED INSPECTIONS
CLACKAMAS, OR 97015 Gas Line Insp
Phone:656-1184 Mechanical Insp
Rag#:LIC 447 Heating Unt Insp
PLM 3-286PB Final Inspection
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W This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. 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 180 days of issuance, or if work is suspended for more than 180 day�5. ATTE ON: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those r I r set f rth in OAR
952-0010010 through OAR 952-001-0080. You may obtain copies , these rules or r uestio fis to OUNC by
calling (503)246-9189:, > \q7
Issue By: Permittee Signatur
Caul(503)639-4175 by 7:00 P.M.for Inspections need the ext business day
KING CITY
15300S.". 116th.avenue,Ring City,Oregon 97"34 2643
Phone:(503)014.4082•FAX(503)639:1771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the Cite of Tigard. mane building related permits
for projects in King (=it;. are issued and inspected by the Cite of Ti; ard.
If your permit application DOES NOT REQUIRE PLA` REVIEW. simple complete the
appropriate application legible and submit it to the Kine Cite staff. The King Cite staff will
collect all fees and fa:; the application :o the City of Tigard. Cite of Ticard staff v,i11 then create
the permit. issue the permit. and perform inspections. Please indicate on the t !rmi: application
whether you would like the Tigard staff to call \ou -when the permit is ready f-jr issuance or
% . e,her ti ou prefer it to b:' mail'-.d ��i:hout an\ notification. A.ny incompiete or iliee;ble
application %till be returned to King Cin staff for correction and no processing will occur until a
complete. lezible application is received.
If your permit application DOES REQUIRE PLAN REVIEW. this form must be signed by a
Kine Cita staff person. King Cite s:a;f .pili simpl% sign this form indicati:a land use approval.
T:'ke this sit ned form to the Citi of Tigard Development Sen-ices Counter located at 1 I SIW
Hall Blvd. Tigard. to submit applications and plans. Development Services Tc:hnicians are
available at 639-4171 Ext. 304 should you have am questions concerning submittal
requirements. All permit fees will be assessed and collected at the Cite of Ticard.
The Cite of King Cite hereb\ authorzes applicant to pursue permits at the Cite of Tigard
N Building Department for the following proiect:
J located at: L JQ1iQ �'w
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King Cite Representati
Ass,.Ci�s,e„�_
echanical Peanut Application
*Da(ereace:ved:: 91 of Permitno.:
City of TigardProject/appol.no.: Expire date:
(•itvofTigard Address: 13125 SW Hall Blvd,%GkWi7223
Phone: (503) 639-4171 Date issued: no.:
_ Ry: Receipt
Fax: (503) 598-1960 tum inn,. Case file no.: Payment type:
Land use approval: Building permit no.:
UN Y iIi��luIi�,.
W 1 &2 family dwelling or accessory U Commercial/industrial U Multi-family ❑Tenant improvement
U New construction U Addition/alteration/replacement U Other:
1111110111 M=
Job address: 1 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value S
Lin: Block: Subdivision -See checklist for important application information and
I'rujca rrar�d;: iurisdiction's fee schedule for residential permit fee.
City/county: ZIP:
fk ri ti n and lo-Aon work on rem-ise�s::t� _
Fee(ea.) Total
Est.date of completion/inspection: j Deacri Rea.onl• Res.only
Tenant improvement or change of use: _ �—
Is existing space heated or conditioned? Yes U No Air handling unit ---CFM
Air conditioning(site plan required)
Is existing space insulated?❑Yes ❑ -'Ateration of existing HVAC system
of cr compressors
Business name: , State boiler permit no.:
_ HP Tons BTU/H
Address: U �) 'Fire/smoke acT mper: et smo a electors
City: _ St ZIP__ eat pump(site plan required)
Phon AL- E-mail: 2 — este rep ace urnac urner
Including ductwork/vent liner U Yes O No
CCB no.: ep nsta rac e rocate�icalcrs--sine
City/metro lic.no.- wall,or floor mounted
Narne(please print): _ ent or aPliance other than furnace
e erat :
AhsorptionunitsBTU/H
Name: _ !\ _ Chillers HP
Address: Cum ressors, HP
1 maema ex arra a ventilation:
City: te: ZIP: — Appliance vent `L _
Phone: Fax: G mail: ryere�x taunt _
%,Type res. tc a azmat
hood fire suppression system
Name: \ Exhaust fan with single duct(bath fans)
Mailin address: x nust system art rom eaun or
a AC
11 _ ue p up to out ets
City: (, Stal T LPG NG (Al
Phon JC� E-mail: P�e—iioneea�c l-addiuonaTover out etsng(ac emeticrequt )
outlets
Name: a�iee ar eq pment:
m Addres fireplace
(9 City Sta IP: e
Wstov pe et stove
J Ph ne: F x: E-mail:
A licanrs signature: _
Nar1r,(print): — r
Permit fee.....................$ ,_ a
Not all ji"idicNane ecce" t cerdx,pkae call juritdkilon for mare Information. -!
Notice:This permit apphcntion Minimum fee................$
U Visa O MastcrC expires if a permit is not obtained
Credit lard number: .a�_ __�_ Plan reV1CW(at �._ %,) $ _
_ Fxphea within IPO days after it has been State surcharge(8`16)....$
PIPE lt7i!W.
Now a(c Idler n OKwn on credit cud s accepted as complete. TOTAL s 1 F4.3D
Cadholder alputtre Amount 4404617(MWCW
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 R 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: J
Description: �' Price Total
U--- Minimum fee$72.5.0 Table 1A Mechanical Code x (Ea) Amt
$1.00 to$5,000
$5,001.00 to$10,000.00 $72.50 for the first$5,000A0 and 1) Furnace to 100,000 BTU - C�
4A 51.52 for each additional$100.00 or Including ducts R vents 14.W
4.
fraction thereof,to and including
$10 000 2) Furnace du s 8 vBentls 17.40
.00._ _ -
$10,001.00 to$25, .00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or including vent z 1400 -
fraction thereof,to and including 4) Suspended heater wall heater
_
$2500000 or floor mounted eater 1400 _---��
$25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and 5) Vent not incl ed in appliance penult 6.80
$1.45 for each additional$100.00 or 11__
fraction thereof,to and including 6) Repair u is
'000.00. 12.15 4
$50,001.00 and up 1150
00 for the first$50,000.00 and Check all at apply: Boller Heat Air
1. for each additional$101`00 or For Item 7-11,see or Pump Cond
fractl thereof. footno s below. Com •_ "
7)131 ;absorb unit
ASSUMED VALUATIONS PER A LIANCE: 801 r e1 U _ 14.w
8) -15 HP;absorb
Value Total it 100k to 500k BTU 25.60
Description: _ Qty a Amount '4)15-30 HP;absorb
Furnace to 100,000 BTU,including 55 unit.5-1 mil BTU 35,00 _
ducts&vents 10)30-50 HP;absorb
Furnace>100,000 BTU Including 1,1 unit 1-1.75 mil BTU 52.20
ducts&vents 11)>50HP:absorb
Floor furnace Includin vent _ 955 unit>1.75 mil BTU 87,20 _
Suspended heater,wall heater or 955 12)Air handling unit to 10,000 CFM
floor mounted heater _ 10.00
Vent not included In appllcance 445 13)Air handling unit 10,000 CFM+
rmit _ _ 17.20
Re it units 805 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 955 10.00 _
to 100k BTU ---- 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 _ 8.80 _
101k to 500k BTU - -- 16)Ventilation system not Included In
15.30 hp;absorb.unit,501k'0 1 2,310 appliance�ermit _ %00
mil.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit,^ J� 3,400 10.00
1-1.75 mil.BTU 1 OTomestic incinerators
>50 hp;absorb.unit, 5,72 17.40
>115 mil.BTU 19) mercal or Industrial type Incinerator
Air handling unit to 10,000 cfm 06 6995
Alr handling
>10,000 cfm 1 70 20)Oth units,Including wood stoves
Non-portable rate cooler 656 10.00
Vent fan ced to a sin I�a duct 446 21)Gas pi ng one to four outlets r
Vent syst(, ncluded in 656 5.40
appliance 22)More that 4-per outlet(each)
Hood servechanical exhaust 656 1.00
L Domestic Itor 1,170 Minimum Perm Fee$72.50 SUBTOTAL:
Com_mercldustrial Incinerator 4 590 72, O
Other unit, ing wood stoves, 656 _-�� 874 State Surcharge
Inserts,etc
- Gas piping tlets 360 25% n Review Fee(of subtotal)
Each additional outlet 63 Required for I_commercial permits only
TOTAL COMMERCIAL a TOTAL RESIDE TIAL PERMIT FEE: _
VALUATION: J �_ 1®,30
1
91hK + _ctlon*an _:
1 inspections outside of normal business hours(minimum charge-two hours)
$72.50 per hour.
2 Inspections for wldch no fee Is specifically indicated (minimum charge-haN hour)
372.50 per hour
3 Additional plan review required by changes,additions or revisions to plans(minimum
chargeUne-half hour)t72.50 per hair
'Stats Contractor Boller Certification requlrsd for antis r200k BTU.
"Raldential AIC require**He plan showing ptacennnt of unit
1:ld9tslfomhsknech-fees.doc 10/11/00
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CITY O F T I G A R D PLUMBING PERMIT
DEVELOPMENT SER°VIr.FS PERMIT#: PLM2001-00286
21 6 13125 SW Hall Blvd.,Tigard, OR 97 t23 ta,.-, "19-4171 DATE ISSUED: 07/05/2001
SITE ADDRESS: 16690 SW MATADOR LN PARCEL: 2S116AD-08300
SUBDIVISION: KING CITY NO. 12 ZONING:
BLOCK: 18 LCT: 015 JURISDICTION: KIN
CLASS OF WORK: ALT' GARBAGE DISPOSALS: MOBILE HOME SPACES:
TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS:
OCCUPANCY GRP: R3 FLOOR DRAINS: TRAPS:
STORIES: WATER HEATERS: I 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: Installation of new gas water heater.
FEES
Owner:
Type By Date Amount Receipt
BOYD, uORIS M 5PGT BB 07/05/2001 _ $5.80 KING CITY
16690 SW MATADOR LN
TIGARD, OR 97224 PRMT BB 07/05/2001 $72.50 KING CITY
_
Total $78.30
Phone 1:
Contractor:
MP PLUMBING CO
MILWAUKIE PLUMBING CO
PO BOX 393 REQUIRED INSPECTIONS
CL.ACKAMAS, OR 97015
Phone 1: 655-9161 Final Inspection
Reg#: LIC 5002
PLM 3-17PB
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FD This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
ao
a Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans.
LU
This permit 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 throug; OAR 952-0001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503) 246-1987.
Issued By: Permittee Signature:
Call (503) 639-4175 by 7:00 P.M.for an Inspection needed the next business day
07/05/2001 09:02 5036393771 CITY OF KING CITY PAGE 01/01
0i1l26/0 FAA 10:01 FAX 503 598 1WUU --" UITY UP '1 WAND RECEIVED JUN 2 9IgJUU'L
". ,JUN 2 5 200 — . - TiJ01
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PlumbwgPernut 'UM It V"
►�t TJatereceived: C Psrmituo. -
f;ity of i■gard Sower permit no.: Building permit no.:
Addreas: 13125 SW Hall Blvd,TiRui,OR 97223 ---
Ciryn/Tiranl Phone: (503) 639-4171 Project/ l.no.: Bxpiredote!
Bax: (503) 598-1960 Date issued: By aeeetpt no.:
Land use approval: T_^ Case nla,te.: Paywenttypc:
O 1:
A T,funny dwelling or accessory 13 Commismial/industrial D Multi-family O Tenant improvesnent
0 New construction ❑AdditiWaltaradon/replacamsut O hood service O Other
Job address: I�eK Few ea. Total
bldg.no.:- Suite no.; 1'aid Z'fa w t
ax tax oVsecarntno.: v� (btd48as108A'�'wraaestul�jo�a�
- - t. Block: Subdivision:
feet name:
ty/county: _ ZIP: _ sch adds onal bat tc n
-cripgou and;pcation of work on premises;� skent'llliks:
Catch bastinfarea drain
t,date of com ledon/ine don: weris
ufaemmd til
me uide0 -
Address: Rain Gin connector
Ci State;n YJ 21P: Sanl sewer no.
Fax: 5bnttn sewer no. n.
CCB no,: Plumb, tle`reg.no: j Water cervico(no. n. _
City/metra 11e.no.: � L -� . '50--L)y Atittvrs on I
Contractor's representative signature: Abse don valve
--- ac ow ventu
Print name: Dttoe: Backwater valve
astnsllays
Name: Clothes vyu t
Ad drt as: -
city: ��— State: L`,. bri ng untain(a) -
T:iP: octora/aum
Phone: Expliffliori tank
Fixture/seseLcap-
4m-Y
- -
Name(print): Floor oor si kow
Miling acldreas: 0�-��0&a�—
a
How bibb
ti City: -- _ State: i�
roe mAir
Phone: -Int6rceptorilgreasetnV
Ntimer in+tal(adon/resldential Insitrtenence only: The actual inetalladon a zK )
will he male by me or the mairttenance and repair made by my regularoo Wn(n currun- c l
employee on the pmpeaty l own as per ORS Chapter 4 47. i s), as (s), ave s
J Owner's si nature; Vile: _ amp
ca flub s owef/showatpan—
F3Urinal
Name:
W Water c oset
res
-� Adds: Water heater
City: _- --- _ slaw: 1:1P: (�:Flc%_W.—
-�-
Phone: ax:- a-mail; rafid
a all Iv+rdkurn..ceeFl ae(et urs.plrr.cull IuMelcNee tbr'eutu In(:rmadon Notttiro:This permit epp)lcation
Minimum fee................$
Visa ❑'MasterCard expires if a permit U not obtained Plan mview(at ,_ 9b) S _ O
"dik"'d 1%1°'°' - -L within 190 days aftm A heal been State surcharge(R%)....S
no
tv.arc a f n erre en pre t c accepted as complete. TOTAL .......................$
— c er.ptawra -- M will NOJAta(61t1afCOM)
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171MST
/!r (_��BIJIP
Date Requested_ — IS' AHA PM � BLD
Location O �'� _ -�� 4 AI Suite _ ���Y11_Dp
Contact Person - Zd�'1 r Ph &.2-0 -- (o gl 3
Contractor _ _ Ph SWR
BiJILDINO `, r Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation f FPS
Fig Drain
Slab Crawl Drain Inspection Notes: ��, ,�L� SGN -
Post&Beam �.G SIT _
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall NailingQ�l/�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
hoof
Misc: I _ - tom_ " �.-I IS-
Final
Final
PA FAIL S \.ti.✓�rt Qll�/,
MBIA 1
earn - r�c.�_ -
Under Slab
Top Out j� n
Water Sery
Sanitary Sew
Rain Drains ��1 - V ` +-zi
l
Rough In L i
Gas ne
i
AS PART FAIL n SAA,
n' ServiceIX
Rough In \ -
N UG/Siab _
?^ Low Voltage
J Fire Alarm
m Final
PASS PART FAIL
a SITB r
Backfill/Gradino ---
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ ,required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Su Line [ ]Please call for reinspection RE: _ Unable to ins
PPIY — [ 1 ped-no access
ADA
Other Approach/Sidewalk Date -, ] �G/,� t
Other ,� inspector � C.� Eo�I
Final
PASS PART FAIL j DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION .MST
24-Hour Inspection Line: 639-4175 Business Line: 639.4171 —
BUP _
Date Requested- Z AM _PM ZU BLD
Location/ 0 Suite (fA--A A:t&I eld Z3 Y
Contact Person _ — Ph Zoo
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN —
Crawl Drain Inspection Notes: -
Slab - SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear —
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
eam —
Under Slab
Top Out -
Water Service
Sanitary Sew —'
Rain Drains
Firi ` ��` -
_P.AFL FAIL
Post&Beam
Rough In
Gas Line --
S oke Dampers
Fina - — ---- --- -
PART FAIL
EIECTRICAL — -`----
Service
Rough In -
UG/Slab _
Low Voltage -
Fire Alarm _
Final
PASS PART FAIL
SITE
j Backfill/Grading -- --- --
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hell Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE _. [ ]Unable to Inspect-no access
ADA v z
Otheoach/Sidewalk Date v`� 1 Inspector V_ J Crr- Ext _
Final
PASS PART FAIL DO NOT REMOVE this Inspect,on record from the job site.