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Permit • CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2001 -00321 _. I DATE ISSUED: 9/11/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134DC-01600 SITE ADDRESS: 11775 SW 114TH PL SUBDIVISION: 114TH PLACE ZONING: R -4.5 BLOCK: LOT: 009 JURISDICTION: TIG CLASS OF WORK: ALT 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: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: 1 Remarks: Install CFX gas insert in fireplace and 20 ft. gas line. Owner: FEES FORNER, THOMAS D /DIANE P Type By Date Amount Receipt 11775 SW 114TH PLACE PRMT CTR 9/11/01 $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 9/11/01 $5.80 2720010000 Total $78.30 Phone: Contractor: GP + W SYSTEMS, INC 732 MARBLE RD WASHOUGAL, WA 98671 REQUIRED INSPECTIONS Gas Line Insp Phone: 360- 835 -3516 Mechanical Insp Reg #: LIC 108176 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 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. 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 rcn217LtR -Q1 P. Issue By: ► , ,� /� Permittee Signature: '72 r mi l- - r�J Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day 09/10/01 MON15.56 FAX 3608355716 Kent & LYnne Kettering II 002 . - A' . • `. A Mechanical Peritr�iWglication . i i 1 . , (7 Datc received: Bic Permit no.: J.," ` 0 /....0 .,„„/__/ 3. City of Tigard Project/appl-no.: Expire date: City of Tigard Address: 13125 SW FlalI Blvd, Tigard, OR 97223 _ Phone: (503) 639 -4171 Date issued: By : , t 5,.. I Receiptno.: Fax: (503) 598 -1960 Case file no.: Payment type; Land use approval: Building permitno.: TYPE OF PERMIT U 1 & 2 family dwelling or accessory CI Commercial/industrial 0 Multi- family 0 Tenant improvement Cl New construction 0 Addition/alteration/replacement 0 Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHFOULE . Job address: 1 7 75 5 to 11 y — apii.e�� Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map/tax lot/account no.: profit Value $ • Lot: Block: 'Subdivision: ;See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: - 7 - [y 4 ezi I ZIP: 9 7 Z Z I & 2 FAMILY DWELLING Pi ?R.MIT FEE SCHEDULE Descri Lion and location of work on premises: r� 4 AND COMMERICAL /INJ)USTRIAI. EQLi1P11I ENTSCHEIULE t ce . ; 24 `Got /. 1F'ee (ea.) Total Est. dat of completion on: 9/26, A) / t Description Qty. Res. only Res, only Tenant improvement or change of use Is existing space heated or conditioned? 0 Yes LI No Air handling unit CFM ., Air conditioning (an required) Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system _ . Boiler /compressors 6 p e- 0C..) 5 S 10-ins c.. • State boiler permit no.: Business name: � ) r � y " , H Tons BTU/H Address; ? L fj fZ4i t � Firc/smokedampers /duct smoke detectors City: it --, h al._ State: it/4_17.1P: 'j 7/ Heat pump (site plan required) Phonc:3 j- in S - 3 shiFax= 835- $wL. E -mail: Install/replace furnace/burner BTU/H Including ductwork/vent liner Cl Yes 0 No CCB no.: lU g/7 Install/replace/relocate heaters - suspended, City/metro lic. no.: ? 955 wall, or floor mounted Name (please print): ' r . ,p,e, ke L Vent for appliance other than furnace CONTACT PERSON Re frig Absorption units - BTU/II Name: AL tit Chillers Hp Address: �� ',momenta' , G, 3 - Coin ressors HP onmenta' exhaust and ventilation: City: , I t .O - / 7 State: ZIP: Appliance vent Phone: !tf /w. . Fax: E-mail: Dryer exhaust OWNER Hoods, Type l/ 1I/res. kitchen/hazmat hood fire suppression system _ Name: /�3Ill 4- D/ 4241e., . y i1 . Exhaust fan with single duct (bath fans) Mailing address: / Ti P7 Exhaust system a art opt heatin or AC City i State: ZIP: - 7223 ue piping an istnbeitio up to 4 outlets) r ' TY LPG N G Oil 50 P = Fax: E Fuel piping each additiona over 4 outlets ENGINEER Process piping (schematic required) Name: Number of outlets Address: _ Other listed appliance or equipment: Decorative fireplace City: I State: I ZIP: Insert - type - Phone: iFa E-mail: Woodstove/pelletst ve / Other: Applicant's signature: Date: ,1 3/6/ — al.: Name (print): ' Permit fee $ Not all jurisdictions accept credit cards. please call Jurisdiction tot more iatontmtioa.‘ Notice This permit application 0 Visa MasterCard Minimum fee $ 4 10 6 a Z g a i i f a ermit is not obtained cm.a. um• k • � 7/ /Q� x F re s p Plan review (at %) $ ,,, 2770 �- t r Expires with 180 days after it has been Name orb,. • • ..,._: - o :. c t card 39 accepted as complete. State surcharge (8 %) .... $ ` ardhaldcr atgnuttve Amount _-. 440-4617 (6f00 /COM) CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 63 175 Business Line: 639-4 , MST BUP Date Requested AM PM BLD Location i f 7 7 , S f / L f ` k t Suite MEC a. DO/ — CO 3 ,- j Contact Person Ph PLM Contractor Ph SWR BUILDING Tenant ELC Retaining Wall jog y ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspect • • "otes: r • Slab '� SIT Post & Beam Ext Sheath /Shear / Q Q )4' 4)2( Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Dampers \AS PART FAIL ELECTRICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Othe�ach /Sidewalk Date 2 ' Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site BUP - Building Permit ELC - Electrical Permit 4 Inspection Description Date Passed By 11 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing - 4 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation Drywall nailing 4 Inspection Description Date Passed By Suspended ceiling Post/beam mechanical c Engineered soils Gas line hl P Welding Lab Final Mechanical rough -in ; h Concrete Lab Final Fire damper Bolting Lab Final Duct work Structural observation Smoke detector Mechanical final ( )LLD / 1 `iii Fireproofing Lab Final Final inspection PLM - Plumbing Permit Ai BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab I Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer .4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04 /17/01 CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2001 -00321 DATE ISSUED: 9/11/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1 S134DC -01600 SITE ADDRESS: 11775 SW 114TH PL SUBDIVISION: 114TH PLACE ZONING: R -4.5 BLOCK: LOT: 009 JURISDICTION: TIG CLASS OF WORK: ALT 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: 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: AIR HANDLING UNITS OTHER UNITS: 1 FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Install CFX gas insert in fireplace and 20 ft. gas line. Owner: FEES _ FORNER, THOMAS D /DIANE P Type By Date Amount Receipt 11775 SW 114TH PLACE PRMT CTR 9/11/01 $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 9/11/01 $5.80 2720010000 Total $78.30 Phone: Contractor: GP + W SYSTEMS, INC 732 MARBLE RD WASHOUGAL, WA 98671 REQUIRED INSPECTIONS Gas Line Insp Phone: 360- 835 -3516 Mechanical Insp Reg #: LIC 108176 Final Inspection N 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 suspende for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Orego Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR Vl 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (Ff1R194R -Q1 Re � Issue By: , ► / / „ ,/I i Permittee Signature: 07 l r .�rey 1 Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day eiskair