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Permit CITY OF TIGARD MECHANICAL PERMIT 1 1', , ,I re. DEVELOPMENT SERVICES PERMIT #: MEC2004 -00507 �� DATE ISSUED: 7/29/2004 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S134CC -03000 SITE ADDRESS: 11960 SW 122ND CT SUBDIVISION: YE OLDE WINDMILL ZONING: R -4.5 BLOCK: LOT: 016 JURISDICTION: 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: 1 DOMES. INCIN: 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: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: • Remarks: Installation of A/C unit. Owner: FEES FARRIS, MATT & MINDIJOE Description Date Amount 11960 SW 122ND CT [MECH] Permit Fee 7/29/200 $72.50 TIGARD, OR 97224 [TAX] 8% State Surchari 7/29/200 $5.80 Phone: 503 - 522 - 5852 Total $78.30 Contractor: CLIMATE CONTROL INC 16500 SW 72ND AVE PORTLAND, OR 97224 REQUIRED INSPECTIONS Phone: 503 Cooling Unt Insp Final Inspection Reg #: LIC 62196 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -6699. Issued By: D_ �'�!,�,� Permittee Signature: SP 1 Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day - _ Mechanical Permit Application ; . FOR OFFICE USE ONLY • C • i of Tigard �A r Date Permit No 6 131 SW Hall Blvd., Tigard, OR 97223 R EC E U `V� [� v Y 00 )5 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 1 �� 'i th Other Permit. D ateBy: Ins ectton Line: 503.639 JUL 2 9 ' '� Date Ready/By: P �, Internet www.ci.t ard.or.us - �+ o MI FL See Page 2 for Notified/Method: t Supplemental Information :::::::::.::i s:u-+: :..... ...4:: : ii , ...:,. ;,.. . . �F:QF.S ` .4 .. ; - - :• *i: .. ti ,,..-.. ....:....:...: . :::.:::::..- . - ., - _.• _ - ....._ ' co; �ii�rERCta> L�??�� : _s�z�����ly�us�;c�i � cx�>i�r �. 1:1 New construction e� tion%rela zmtVnt Mechanical permit fees* are based on the value of the work performed. indicate the value (rounded to the nearest dollar) of all El Demolition ❑Other: mechanical materials, equipment, a b overhead, and profit. -....-.,- :i4ii:: i:ii::;: ::': ,,,: 1=: a:;ex. C TE:CORXi:O:)H €i'CON TRU Val ue: RESIDENTIA E Q; UTPFENT 'J'SYSTEMS: *..; ' and 2- family dwelling El Commercial /industrial I=1 Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: : :::_ :::.::::::.:::::. ...•_:.:. ::: -:_:__ s :: .... ; . ,:., r :..::: Description Qty. Ea. Total :::: -. ..... .... , . ' h si 1 , 7:-. r [ii ' JOB SI`)E'E� INFORIVTAT1ON > 'AND'LOCA9'ION. • • @Heating/cooling n Job site address: 1 l v! l.�.CJ S w aD,✓t �� ,, _ Air conditioning or heat pump L l 1 (requires site plan showing placement) i 14.00 I f City /State /ZIP: ; G k / D� r`� -7 2 LI Furnace 100,000 BTU (ducts /vents) 14.00 _I ! Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: 6, SS _•"lam', Duct work 14.00 Flydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel - type, not electric), ' in - wall, in - duct, suspended, etc. 10.00 Subdivision: Lot no.: Flue /vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances . :: .:. :::.:.t::. «.;.,.._,. -.. -. T Y)1 ''OF: W Water heater Yl �j`GL I Qlf (1 Gas fireplace 10.00 l C(w1Gt l T 10 v1 t t2 LL (T Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10 00 10.00 • ::.:. : ..... 1; " Chimney /liner /flue /vent - :: ._ ::- :.:::,::,:,. - PR .TENANT ... � ter- 10.00 Name: M0,-}-i- ! v t I V) G� t \ 0 Q., � 0.� , r'\. 5 Environmental exhaust and ventilation Address: \ �} Range hood /other kitchen l l w aa� �� , equipment 10.00 City /State /ZIP: ; () ,--„ Al --- c,\\ 1 O' - A - 7 ---d-2--.L.-1 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (�?,) . _ S --„, Fax: ( ) toilet compartments, utility rooms) 6.80 .'•-•• ?: '; ; '' 4AFpLI46{`iR g; = : ': ;'; I a VI CONTACT PERSON :. -.. Attic /crawlspace fans 10.00 Business name: G 1; � In ` l r6 Other: 10.00 r Fuel piping Contact name: I� � ` '^ ', A CI E� y llu 55.40 for first four; 51.00 far each additional _ Address: ( 1.f✓ 500 •5L ) •7 - )n 7V Furnace, etc. Y Gas heat pump City /State /ZIP: ?0c- . ,, 6 CI K 6)-7 / _J Wall /suspended /unit heater Phone: ( 5b3) t15 5 - �5 a- -D / Fax:: ( c ,.� at Water heater E -mail: Fireplace Range ::.:- :........: �;::: iy ` GONTRACTOI2:.'::' '':::: . t • 8arbeco t Business name: C v V „ ` 0 . c 4 Other: dryer (gas) Au-p_____, ' , er: Address: , ("r-Cr) -5 Lk.) `n. .�YIJ.-�__ .. .. . . . y . ..: -.. .... . ' 10EUF .- VNIC E RMET F EES* .. City /State /ZIP: TO C-f 1 a...A.A & C--- ' t-----. 9 ?-D-'14 Subtotal I y )� ' 1 Minimum permit fee (572.50) - 1 a • 50 Phone: (St,) �� 3 - v i �aa (Fax: ( Sb Rim- - 7 Da Cp. Plan review (25% of permit fee) , -_ l, CCB lie.: V 1 1 9 • State surcharge (8% of permit fee) . 6o , ‘14. TOTAL PERMIT FEE - 12) , �c> Authorized signature: vl,i This permit application expires if a permit is not obtained within ISO I days after it has been accepted as complete. Print name: IL A`t P- I ( � \ \ l^ • / , Date: 7 /ail /3 44 • Fee methodology set by Tri- County Building Industry Service Board i.\ Building wermits\MeC- PermitApp.doe 12/03 \ I ` 440 -4617T (I 1 /02/COM/ 1 . d i7ZZL 896 COS 1 o..rquo w t T o ed I :6D VO 6 Z I nC k. DEPARTMENT OF LAND USE & TRANSPORTATION LAND DEVELOPMENT SERVICES DIVISION #350-12 Ilk - WASHINGTON 155 NORTH FIRST, HILLSBORO, OR 97124 011ic COUNTY, PHONE: 503/640-3470 OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415 P ;:.:r s • . . , .. . — --,,,, •: i. : .: .; : - '. - -0'.: -;J:, : , r .-.. .'..... - >,.' . . - ,_ .. 2 ", .;,:- :: ; j- :--....:. c.O. • ," ,:'. ,/ .-.1 1 . L. st' .=. '. 2 / 2 . / .- - 0 ... P...i • . . . -,, ,.. :: • - :1; 7". ,-* .. t : . " ''' , ' ::.. .:, / • '. 4 • ... `,1 ': ,':'.2N:;) 1" _:......;,) O w ' , - , -.. :' 2. , .. -• . ' , • ',.7:, 7 - . s.-- ;,L - .,': - '21 :'...1'.. '7 T '1. :k )t1 . .. -,. , . . _ _ _ ... I ..i - . • . i -- -7Z? - --, --gde--Xe"--c ....---'-'. . - -..--...-'.. -. . _ / ,, TD ,- .. &zed ,,_.. , "001/.." ...- . d _ _ . . A ._____ .. __ .. ___. ..._.—. _. ____ .. __.... ___ _,,Z- _ _ . . . . ,.. .. . • _ _ . , _ _. . . ..._. ... _. y--A - - - - -----,- , .. _ . .. . _ _ ...... _ .. .. .a4,42_,-) ... _ .. .. __ . . ._... . ...... . - • - -------- ._ . ... ... . _ \-- __._ _ ..„...._.. _ . . . . , . . ' i iiiii, ,.., DEPARTMENT OF LAND USE & TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350 -12 155 NORTH FIRST, HILLSBORO, OR 97124 COUNTY, PHONE: 503/640 -3470 O REG O N INSPECTION REQUESTS (24 hours): 503/640 -3561 or 693 -4415 , p , • .. , s • ': •? ,. r '.11. - c .., ,,, . ': a 3 : /'; •Pen:. . • , T - s. .. , ;: 1 t ' : . aver . . , : ., t_.. _ • .. ,i'i 4 •' • . ..14 . .2N: O W 14 1 is _ .. _- , - _ .. .:a : ".. - -- t L ii G- -i. .SIi:..: -:. . . ..... . . . .. .. ..... ' - - --... .. ...... ... ......-,. - .... ....-.......... - --.....-. ..-- . - sow • . - -. .., . .../ . , f • A. n .1' . v • " . ' . . . _r • Fl ... ,.' ... 7 5 f , J DEPARTMENT OF LAND USE & TRANSPORTATION 4111W WASHINGTON 155 NORTH F RST, HI TERM O, OR INSPECTION REQUESTS: 503 /640- 3561/693 - 4415 COUNTY �. f PHONE: 503 8464061X - - > 640 -3470 OREGON Page . 1 of 1 Date : 08/25/94 Time : 15:24 Permit Type : Residential Electrical Permit Permit # : 05057525 Permit Status : APPROVED Applied : 08/25/94 Situs Address : 11960 SW 122ND CT TI Issued : 08/25/94 Permit Title : SFR - BURGLAR ALARM Completed : Permit Descr. : NEAR KATHERINE CT To Expire : 02/21/95 Project Title : SFR - BURGLAR ALARM Project # : P0043335 Project Descr. : NEAR KATHERINE ST * EROSION * Parcel Number : 2S1TI - Land Use District : Valuation 0 • Legal Descr. • Owner : ACCENT CUSTOM HOMES, LTD. Construction : OTH Applicant Name : ADT Classification : 900 Applicant Addr.: 703 NE HANCOCK Occupancy : R3 PORTLAND OR 97212 Validated by : MJF Applicant Phone: 626 -4249 Inspector Area : CONTRACTOR : ADT SECURITY SYSTEMS Lic. C 26 -209C 284 -3265 Fee description Units Fee /Unit Ext fee Data Limited Energy /Alter. /Extension 1 40.00 40.00 Subtotal Electrical Fees: 40.00 State Surcharge of 5% 2.00 Total Electrical Fees: 42.00 * ** Fees Required * ** * ** Fees Collected & Credits * ** Method Check # Receipt No. Date Payment CK 8449 08/25/94 42.00 TOTAL THIS DATE * * * * * * * ** 42.00 • Fees: 42.00 Adjustments: .00 Total Credits: .00 Total Fees: 42.00 Total Payments: 42.00 Balance Due: .00 NOTICE: This permit becomes null and void If the work or construction for which it Is Issued is not commenced within 180 days. Once construction has started, the permit becomes null and void If construction Is interrupted fora period of 180 days. I certify that the information presented by the applicant and his agent or agents in support of this permit Is true and correct to the best of our knowledge. I acknowledge that the Building Department's reliance upon false and misleading information may Invalidate this permit. All provisions of applicable laws and ordinances governing the construction and use of this building or structure will be complied with whether or not specified on the plans or noted on the plans correction sheets. I acknowledge that the granting of a permit does not grant authority to access private property or to use easements. I further acknowledge that the use or occupancy of the structure or building permitted depends upon my calling for inspections at various times during the process of construction and the building inspection staff verifying compliance with the various codes. Use or occupancy of the building or structure permitted prior to approval by the Building Department Is solely at the risk of the applicant and such use or occupancy Is revocable until all inspection requirements are satisfied and approval is given by the Building Official. I further acknowledge that a lien may be placed on the title of the property upon which the permit is issued specifying that the use or occupancy of the building or structure is provisional and revocable until the satisfaction of all inspection requirements. APPUCANT'S SIGNATURE • Alit WASHINGTON COUNTY RESTRICTED � Department of Land Use & Transportation �� � i Inspection Section ELECTRICAL ENERGY ' 155 155 North h First Avenue, #350 -12 Hillsboro, Oregon 97124 APPLICATION Information: (503) 640 -3470 0 Fax: (503) 693 -4412 PLEASE PRINT Please complete all sections, 1 through 5. Permit No. 5 5 Z 5 • 1. ress � tall5tion { � �� Date g - 2 C — 4 j Address l o of ins . eoi"j .. CC VU City i , 401-2 Zip Code 4. Type of work: Map No. 25 1 I I Tax Lot ' CAS--S— /(� RESIDENTIAL Restricted Energy Fee $40.00 Thomas Map Book: Page Section ` (for all systems) C am, — Check type of work involved: Directions /I.U.�JIJ (,1 1 Audiwand Stereo Systems* Commercial Residential 11-- urglar Alarm Tenant Name Telephone Systems* (if commercial) Garage Door Opener* This permit becomes null and void if the work authorized by the Fire Alarm permit is not commenced within 180 days from date of issuance Heating, Ventilation and Air Conditioning Systems* of such permit or if the work authorized is suspended or abandoned at any time after work is commenced for a period of 180 days. Vacuum Systems* Electrical Permits are non - refundable and non - transferable. Other 2. Contractor application: . Electrical Contractor A -1.-- COMMERCIAL Fee for each system $40.00 (see OAR 918 - 260 -260) Address 763 .#4 i A-/Vl'�CA_ PI X q 7 re-- Check type of work involved: Date '-..2 V/ -t/ Job Nu ber Property Owner 6. /1-R .V I-he 'rS e 7/ Contractor's License No. .,2/ r ZD J Boiler Controls Contractor's Board Reg. No. ,5" 9 947V _Clock Systems Phone No. fl1 324 g X,3 5 , _ Data Telecommunications Installations g Fire Alarm Installation 3. Owner application: _ HVAC � 9e---2 ?-2 5 _ Instrumentation Print Owner's Name Phone No. Intercom and Paging System Landscape Irrigation Control* Address = Medical _ Nurse Calls City State Zip _ Outdoor Landscape Lighting* This permit is issued under OAR 918 - 320 -370. The applicant agrees Protective Signaling — to make only restricted energy installations (100 volt amps or less) Other under this permit and to do the following: 1. Only use electrical licensed persons to do installations where required. (Certain residential and other transactions are exempt ( Number of Systems from licensing. These have asterisks (). All others need licens- ing) * N o licenses are required. Licenses are required for all other installations. 2. Call for an inspection when all the Installations under this permit eq eq are ready for inspection. 3. Purchase separate permits for all installations that are not ready 5. Fees for inspection when the Inspector is out to inspect under this /) permit. Enter fees $ v 4. Assume responsibility for assuming that all corrections required by the inspector are done, and 5% Surcharge (.05 X total above) Z 5. Assume responsibility for calling for a final inspection when all of g the corrections are completed. The person signing this permit mus • e the app • ant or a person Total $ L'Ft. authorized to bind th - : • • . nt. / Signature /AK. ` ��_ Space below reserved for validation.. wr- Authority if other an = . • licant For inspections call • 40 -3561 or 693 -4415 24 -hour recorder, one working day in advance of need 4/94 DEPARTMENT OF LAND USE & TRANSPORTATION WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350 -12 155 NORTH FIRST, HILLSBORO, OR 97124 IV CDUN PHONE: 503 /640 -3470 OREGON INSPECTION REQUESTS (24 hours): 503/640 -3561 or 693 -4415 Alp .' . _ . r • . r ' .', C ... ' ' o- : / ... _ / '. • d; i. x •;.' i :Y' . , 7'2 / ti / ' ' ` . / , ! •. - " I. Ater: '' .. ... . . T . .. . .. _ .... „a . _ _ _, ._ . . ...... _ __ _ _ __ ....--. _ _ _ . _ _ - ..- ,1/1 7, ;- r . :,! //-1\-- -A " DEPARTMENT OF LAND USE & TRANSPORTATION LAND DEVELOPMENT SERVICES DIVISION #350-12 WASHINGTON 155 NORTH FIRST, HILLSBORO, OR 97124 IV COUNTY, PHONE: 503/640-3470 O _ INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415 P e r:.i • '.. : ,-: -::", . :%..- ,..,:,,.. z .-- - t • l2t - 2.:-..:1 • ..:8/./ 1=hc, . 02/21/9' . ' ," /*/4" •"-.- - ! 1 1 :-.,.• Perea.;7 :::..1. ' - .1'''.).e. 'ii Y .' _I ?- 1;:i A l;': DeSCIr.,r. :‘,.. ,INi;. C Job 3 : .I.Jo: ,i;I,'; .-221.q O w, - ,.-.!:. ,._:4, • ', - EX': CZ Phon. ".:' f , . t.1, :` r 3•,.. f... 1 . ...... i r -'I ' z .:-.) n . :-. , .,-. . • , ,..., ._ . _ ..._ ... • ., - • — • • --- .. . .—. , . t ' . t:: ..- . . — .... • .— _. _ .. . _ . . _— .-- _ . -- - — _. —. .. — ..--- - - ... - — - . . - -- - --- ..;-: ' • 1 / . I: . ,.'.. .t. ! 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'7.'D _ � ; In \ / ` \�. 13 --�---- ' ' ' m • - CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2004- 80507 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/29/2004 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 3/28/2005 TIME: 7 :10AM PAGE: 61 IZ/ f SITE ADDRESS: 11960 SW 122ND CT CLASS OF WORK: SUBDIVISION: YE OLDE WINDMILL LOT #: 016 TYPE OF USE: PROJECT NAME: FARRIS . DESCRIPTION: Installation of NC unit. OWNER: FARRIS, MATT & MINDIJOE, P HONE #: 503 -522-5852 CONTRACTOR: CLIMATE CONTROL INC PHONE #: 503 -453 -4822 Inspection Request Scheduled For: Date: 3/28/2085 Pour Time: • Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 002978 -01 503- 453 -4822 V / /;'m io Corrections /Comments /Instructions: °(c & - 7I.C73 MEM -ASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 52- a J Phone #: (503) 718 - • CITY OIF TIGARD 24 -Hour BUILDING - Inspection Line: X5031639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received I t Date Requested (t � AM PM BUP Location Suite MEC Contact Person Ph ( _ ') PLM Contractor Ph ( ) SW: 'M lauLi BUILDING Tenant/Owner /..3 — 11 7 S73 • Footing Foundation ELC Ftg Drain Access: KAY CIE-We VA/A/ s i ELR Crawl Drain I mo ( ST. - Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear ��/� � - , ,q —00 a 32 s 11111.1r Framing v !/ v © Insulation Drywall Nailing v , < . r'- Firewall Fire Sprinkler Fire Alarm �Z / p Aciv 7 IF Susp'd Ceiling Roof Other: Final Akk U t`A I ht / 6 A" 4 i° PASS PART FAIL PLUMBING M 4 -->( AcIM p Post & er Slab U � � ° Under l._ Rough -In Water Service Sanitary Sewer • Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL :MECHANICAL Post& Beam Rough -In Gas Line Smoke Dampers Final PASS PART FAIL CTRI S • Rough -In /, UG/Slab G'U Low Voltage / Fire Alarm PAS PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. E Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA Approach/Sidewalk Date ( 78' 0,c_ Inspector Ext Other: Final DO NOT REMOVE this Inspection rec d from the job site. PASS PART FAIL