Permit CITY T1,® . r CH�aJkCAi_
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DEVELOPMENT S ERVICES F'L- RM I T . .
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C:98-0244
Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ' ISSUED n 0 / 2 / 18 '
PARCEL: 2S111CD- -I[!'Hoz '1
SITE ADDRESS... e 098921 SW,.RIMBERLY DR , - .
. SUBD I',S-I S I ON. , a . 4 KERWOOD ESTATES Z ON I NG s , R- -'4•'. 5, , ,
BLOCK, p e o LOT e „ 4 ,. JupISLICT ON 'T'IC, '
'
ivLA55 OF WOLF ;� , ^F�1 T__ 1:1_'�iO'R 1= 1S1ti�`� - - -„- - E�1.i'lr' 'C.C!(LCiCia q��, _,_._._._ ;'1
' ` TYPE OF' USE e ..;;SF: UNIT • HEATERS:. z. 0' • VENT FANS ''0'. ' . , . ' .1 .
OCCUPANCY GRP e ; R, 'VENTS W/O iP'P'L'u 21 VENT ��` {,ST;�'MS'o, :,° .
STORIES. „ o e e ... 2. QI BOILERS /COMPRESSORS , HOODS. , . e - a e icZL , ,
FUEL TYPES---- ._,.-__- - - - - -- ' . '•Z Hp.... ; 1 DOMES'.. It-C XN: .(Li • • ,
2t3PIS 3 Hs', , e o,4 0 COMML I NCIN 0
IIIRX .INPUT o IZi BTU 15-' -321 HP'., . , . ; 0 . . REPRIR. 1. #NITS; ' t ' ` .
FIRE DAMPERS?. . 2 30-50 0 HP. 0 o .. tZi WOODS T O' ES.> , 4,0 '
GAS PRESSURE... e 50+ FIR.. , . o 0 • OLD DRYERS.•. 4 . 0
NO'o OF UNITS------ - - - - -- ?SIR HANDLING UNITS . OTHER UNITS. ; . 0 ,
FURN < 100K BTUs 1 <= '10000 cfm e 0 'GAS OUTLETS,; 1
(:i ;RN > =100K BTUe 0 > - 102100'.cfni4 0
Re mark s o Alterations and installation of exterior A/C unit to residence. Unit '
cannot be placed :within the required setbacks.
_ - - - - -- - - -- - - - - -- -- - - - - -- -- __- .. - - - -- - - - -- - - - -. F=EES . -_�.- ,_...- _:.__._.w =_. _
,PHI L. I' O' TW 'ICH ' ' • • type G :ni0unt Li» ',d=r 4 er - recpt
9890 :S!W R1Fr1BERLY DR' ' , ` ' ' .PRMT :V' 5 :00 •DLH'. ,0;^,/ ' =' /C18 08=306761.
TIGARD OR 97:2 '-; - , ORCT ,7'„ .� , 1.25 r , _. 7
•
F'honr:' #ke 6c01- -L-52E ,
Contract or - - - -. ----.._----- :"--- ------- •-- _•---- - - - - -' -
COLUMBIA HEATING & COOLING 'INC •
PO BOX 230397 .
. • < 26. T OTAL'
, r �R�1 9 7 � ; -
J BART.") 1.3 1'\ :.I I_ e__ �t •
Pho #; 62'4 -2704 ' •
Re 12 . #k.. o 000763 ,
' - - - - - --
REQUIRED ;T'NSPECT IONS • - -._. - - - -_: .
This peroit is issued subject to the regulations contained 1.71; the ' IG'a.s Line Inso , __ _
T Qard Municipal Code State of Ore. Specialty bodes and all other Mecl pan 1 ca 1 I n s p_ ' _._._ ,
applicable laws. All work' will be dune in accordance with , Heai,.ino , Unt - Insp . , ._ ___
&proved plans.' This pe,�nit rnil-e4oire'if work,, 's, not started Final Inspect, ion ' _, . -
within 180 days of i,s,uUnce or if work is suspended, for gore -
than 1g days. „ATTENTION; Oregon' law retalllre5 you to follow rules"' . _ ' `_ .� __-.�_ _.___�_..�. ', .
adopted by'� }he' Ore gon,Uti lit y �latifseation'Cetter: , ThoSe Mules are , _ ___._,' __ ._ . __
Set forth in OAR 952-ZiZI1 1 tiraurh.`OAR' - 11t,B i. -You, r.�ay. . • ,._.�.,.__.. ;I -
obtain copies of these•.rulea or, direct questi'onie to OU C by calling, ' _____ _ -___ ' .. . ___ — _.� _ ,
(50,3)246.-9167.: �.��_
:sssi_re B�f _� _ - -- Permit•tee ,Sig,n. airy ; :_ # , /./ ;1 ' �'
.. I_4.,.{. i- +_- 4-•1• ++±4..E. i-.i.•- 1- +- 1- .c.1-4-4- 1-4. i -_;._! -1-- 1- +++i.-1--}- + ++ +i._ - ... }...;.i.t..++- 144-; - ..4.4:1 -++• 7i--F..E- 1- +-9••-! +.4.--
Call 639-4175 by ;00 p. to. - for :±nSpection= needed t he next business day
°r 1 -.s. a . ; .. 1 t ; .: ; ... } • :-'t-'t-a.... .¢..}..r,_::.1 - -1 -- t...= t- 4.4..7.4-4- 1 -_, _ t .. q ,.. ¢ .. } ... y = . ' - � ;-.4 7 1- . u..'r..a- -.1.•1•._t-4 i- -r-1--i• .-4.- - 1--t..- 1.-.1 -t=•4•.-t.-t.._t...l••:..;:.-r-
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By ALlA
13125 SW HALL BLVD. Commercial and Residential Date Rec'd G /zz/9,P'
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Permit # /9F a 9 /
-o
Print or Type " ►/ `1EC
Called
Incomplete or illegible applications will not be accepted
' e 1 of Development/Project Description
I41 L 7r O T Jia < Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address q j ,t,J jn/3 y Die,
Bldg# City /State Zip 1.) Furnace to 100,000 BTU 6.00 /
T/mr�R0. D!2 9 ac-( including ducts & vents (0 -06
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner T/ f / L o 1 - j including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
p
SW .5L() f/ Ly i t including vent
CV /State Zip Phone 4.) Suspended heater, wall heater 6.00
/1 /lgan 02. 9'77,24- (' 'j - or floor mounted heater
Name (or name of 5.) Vent not included in appliance permit 3.00
6)/71 'P.. a s ct-O Q
Occupant Mailing Address 6.) Boiler or comp, heat pu , air cond. 6.00
to 3 HP; absorb unit to 10
Cdy/State Zip - Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU**
Contractor a 8.) Boiler or comp, heat pump, air cond. 15.00
U) ((fin i t a- 1-1-fili 7'/ i1)G 15-30 HP; absorb unit.5-1 mil BTU
Prior to permit Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy Po . T3ax a‘306397 30-50 HP; absorb unit 1- 1.75mi1 BTU"
of all licenses 40/State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if att .) 04e_ q2a� ,S > 50 HP; absorb unit 1.75 mil BTU
expired in COT or on Const. Cont. Board Licit Ex . Date 1 11.) Air handling unit to 10,000 CFM 4.50
database 2�p,3 ,S / a -q�✓ -( -.
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City/State Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration ' Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential4 Non - residential 0
Additional Descnption of work: 17.) Domestic incinerators 7.50
EXTER /pl _ 197e t.c.Ni
18.) Commercial or industrial type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas.j LPG 0 electric 0 23.) Gas piping one to four outlets / 2.00
Uv
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL M
laws c g
Slgna i i i i : of Owne I t Date *SUBTOTAL `
IF 5% SURCHARGE
o ct Person • ame Phone PLAN REVIEW 25% OF SUBTOTAL
ch i 0r'nn /urid ((?`7 ,70� TOTA a
i.\rnechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge
- Residential A/C requires site plan showing placement of unit.
9,
HEATING & COOLING, INC.
P.O. Box 230397 Tigard, OR 97281 -0397
(503) 624 -2704
< 0 2o , „2,0
•
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CITY OF TIGARD BUILDING INSPEAK DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
14(15 Date Requested 1— / 5 — q 8 S AM X PM BLD
Location C lgg0 SW (6.ArY1 ZA Suite CEO 9?-0044
Contact Person S h.Qait1Y '-' Ph Gzq -2...7OL PLM
Contractor C "_ reitA h b 4_.OV f Ph SWR
BUILDING Tenant/Owner Phi 1 ' I Gh (O " 6 Z6(VP 9 Th' 3
Retaining Wall ELR
Footing I 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 52,4 � ` 2 e
Susp'd Ceiling _
Roof
Misc:
Final �
PASS PART FAIL
PLUMBING 6/9-5 7 /A 1)/pc • 57c4aF
Post & Beam
Under Slab Oar , f v T �/ 1'S -
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
FAIL,
'out v
ampers
L ;
� :T FAIL
CTRICA
Servrcrr
ough I
- - =.
Low Voltage
Fire Alarm
Fina
ASS PART FAIL
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 ^
Other oach /Sidewalk Date / //17 f e Inspector Ext
Final
PASS PART ' FAIL. DO NOT REMOVE this inspection record from the job site.