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13534 SW Clearv.iew pl . ----
CITY OF TIGARD BUILDING INr-;PECTION DIVISION
24-Hov Inspection Line: 6394175 Business Phone: 6394171
Date Requested: ' 9 -7 A.M. P.M. _ MST:
Location:__t 3 f 3 'e Sill C L CA/ZL)i 6&_,, p fL
BUR
Tenant: Suite: 7
_ r Id6: MEC: Q
Contractor:_ Phone: PLM:
Owner:-- Q tCAw �CA (_� _Phone: EI C:
FLR:
SIT: _
BUILDING BLDG(con't) PLUMBING MECHANICAL ELECTRICAL ,CITE
Site Post/Beam Post/Beam Post/Beam Cover/Service Sewer/Storm
Footing Roof UndFI/Slab Rough-In Ceiling Water Lute
Slab Framing Top(N,t Gas Line Rough-In UG Sprinkler
Foundalion Insulation Sewer Hood/Duct Reconn%ct Vault
Bsmt Ot!mp Drywall Stam Furnace5 l qtr Temp Service MISC.
Mason Ceiling Rain Drain A/C &f UG Slab
Shear/S'each Fire Spklr/Alm CmwVFound Dr Heat Pump Low Volt
Approved Approved roved Approved Approved
Appr/Sdwlk Not Approved Not Approved o roved Not Approved Not Approved
FINAL FINAL FINA FINAL FINAL
LAd .1-0a
----�`�---�Q.�,2N�E . tiJ Or7!c c/o`r�/�v_ �,�,,��c 23�•�-f
0 Cell for reins nn i 1 RcinVection fee of Srequired before nest inspectiau O Unrble to inspect
Inspector Page _of_�_
CITY OF T MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW HAII Blvd.,Tlgeld,OR 97223 (503)639.4171 PEERi'?r #. . . . . . . : MEC II
DATE ISSUED: 02/25!97
PARCEL: 2 S 104DC--041.00 i
9TTE APDRESS; . .. : 1357/,. SW CI_EARVIEW PL.
SUl3ID I V I r I ON. . . . : BENCHV I EW ESTATES ZONING: R •4. 5
BLOCK. . .. . . . . . . . : LOT. . . . . . . . . . . . . :41
`'LWS S OF WORK. . :ALT FLOOR TURN. . . . : 0 F_VAP COOLERS: 0
TYC- OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
13CCLJPANCY GRP. . :tau VENTS W/O ARPL: 0 VENT' SYSTEMS: 0
T)TORIES. . . . . . . . - 0 BOIL.FRS/COMPRESSORS HOODS. . . . . . . : 0
frUEL. TYPE r..._..____._._ ._.._. _._. 0-3 HP. . . . r 0 DOMEr. f NC I N: 0
: /GAS/ / / 3-15 FiF'. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15---30 HP. . . . : 0 REPAIR UNITS: 0
TIRE DAMPERS?. . .- 30--50 HP. . . . : 0 WOODaTOVES. . : 1
f3A5 PRESSUPE'. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS----------- A I rZ HANDLING UNITS OTHER UNITS. : 0
rURhl ( tOOK BTU: 0 ( = 10000 rfm : 0 GAS OUTI-ETS. : 1
FrURN )=100K BTU: 0 ` 1.0000 cfm: 0
Rpmarks : Tnstallation of gas stove and piping.
Owner: --.-___________________ _..__.__._.___.------_-------•_-____ FEES --------------
r11..1_r..N Bcnis type camofrnt by date recpt
117-4 SW C'LEARVIEW P1_ PRMT $ 25. 00 DRA 02/25/97 97-290851
5PCT $ 1. 25 DRA 02/25/97 97-290851
Phone ff:
FIWNFR
Phone 0 :
Peg fr. . :
REQUIRED INSPECTIOhlS ._.__._._......_..
This pereit is issued subject to the regulatiens contained in the Gas Line In sp
Tigard Municipal Code, State of ore. Specialty Codes anu a'l other Mechanical I n s p
applicable laws. All Mork will be done in accordance with Woodstove Insp
approved plans. This pereit wil! expire if Nark is not started Final Inspection
within 188 days of issuance, or if wank is suspended for sore Final Inspection
than 188 dais.
I s s i-te d F3
Call f o, 1 :0, inn 629--4175
Permit #:
Addres-
IL-1: _ —/-- -- -
lstiucd hy: (, C Date o1-aS`r1�
►859 _
Statement: Information Notice to Property Ov.,ners
About Construction )Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction pe"Tnit appli-
cants who are not registered with 'he Construction Conlractors Beard to sign the
following statement before a building permit can be issued. This stateme?,1 is required
for residential building, electrical, mechanical, and plumbing perpilits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with tl,e permit.
Fill in ti►e appropriate blanks and initial boxes I and 2, and either box 3A or 313:
1. I -)wn, reside in, or will reside in the completed structure.
2. I under,,tand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
3B. I will be my own general contractor.
LLW
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. I:1 change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and(it)understand the Information
Notice to Property Owners about Construction Responsibilities on the re%erse side of this form.
4�..1.1_ 41-IA C-L
(Signature of permit applict:nt) (Date)
(White copy to issuing agency pennit file,
pink copy to applicant)
information Notice to P'r�per#y Owners
About Construction Responsibilities
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EMPLOYER 9EESPONSIBILME'S'.
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Plan Chec
CITY O'= TIGARD Mechanical Permit Application Reed By4„ _
13125 5W HALL BLVD. Commercial and Residential Date Recd
TIGARD, QR 97223 Date to P E
(503) 639-4171, x304 Date tc DST _
Print or Type Permit tt
Incomplete or illegible applications will not be accepted Called _
Name ut DevtnopmentiProlect Descnpticn
Table to Mechanical Code CITY PRICE AMT
Job Street Address Suite# A) Permit Fee 0- 0- 1(TOJ
Address 5(k) (_ Lev✓ru'r
2i(Iqo Cdylstate Zip B) iupplenmental Permit 300
Name Ior name of business 1 ) Furnace to 100.000 BTU~� 6 00
Owner i , , incl ducts 8 vents
Mailing Address 2.) Furnace 100 000 BTU+
7.50
:3"-" r incl ducts&vents _
C tpStateZip Phone
3, Floor Furnace 6.00
N" y " < r" -(�f 4 L� mct vent
Na .t fornemso business) 4.) Suspended nc _r,wall heater 6.00
i or floor mounted heater
Occupant Mailing Address 5) Vent not incl in —300
appliance permit _
Cny,state z p Pnone 6) Boiler or comp,heat pump,air Gond. 6,00
_ to 3 HP.absorp unit to 100K BTU
Contractor Name 7, Boder or comp,heat Dump,air Gond. 71 On
(Prior to `11_ly, r) 3-15 HP;absorp unit m 500K BTU
X, _ __ _
isvuance Mailing Address Boder or comp,heat pump,air Gond 15.00
applicant _ 15-30 HP,absorp unit 5.1 mil BTU
must provide all Cdyistate Zip Phone 911 Boder or comp,heat pump,air cons. 22.50
contractor30.50 HP.absorp unit 1-1 75 and BTU
license Oregon Const Cont Board t..ic M Exp Date 10) Boder or comp,hoa' .mp,air Gond 3750
information >50 HP,absorp ur l 1.75 and BTU _
for COT COT Business Tax r Metro a E.p Date 11 ) Air handling unit to 450
database) 10.000 CFM
1_ _
AfCltic@Ct Name f� 12) Air handling unit 7 50
���r1 10.000 CTM+_
or Marling Address -- 13) Non portable 4 50
evaporate cooler
CdyiState Zip Phone
Engineer 14) Vent ran connected 3 00
to a single duct
Describe work New O Addition O Alteration O Repair O 15) Ventilation system not Y 4 50
to be done Residential O Non-residential O included in app.liance permit
Additional Description of work 16.) Hood served by mechanical exhaust 4 50
Tr-)-, - ,��r (rcf gait Prp)tty �b
G-PJ mad Shue- t7 _17) Domestic ncner-torn _ — 7 50
Existing use of 18) Commercial or industrialtype 30 00
budding or property incir.crator
19) Repair units---
4 50
Proposed use of 20) Woodstove 450
budding or property
I _ _I. f�C,
21 t Clothes dryer etc V 4 50
Type of'uel-0110
odO natural gas LPG O electric O 22) Other units a 50
I hereby acknowledge that I have read this application,that the 23) Gas piping one to four outlets ) 200
information given is correct.that I am the owner of authorized agent of
the owner that plans submitted are in compliance with Oregon State 24) More than 4-per outlet (oachl 50
laws
Signature of Owner/Agent Date, ! _ 0-Y.SUSTOTAL
' , G
Contact Person Name Phone 506 SURCHARGE
PLAN REV-IE-LV 45°b OF SUBTOTAL
+ TOTAL of
fu
i'dstimechpmt doc (rev 7/96) 'Minimum permit fees$25+5%surcharge