Loading...
13735 SW BULL MOUNTAIN ROAD L-LoPPL �� , I w 1 APPLE (F OSSIBLEI BUIL NG 0 BE SAVL� ) ro 3E I1 14 4 'APPLE I REMO ED ! -- _ --� 0 --- 1_ 8 1 LOT 7 1 `� TREE TO BE REMOVED I icn 49 ! AND MITIGATED �+ ! evrv2. 16 7" APPLE QA 1 x.00 `' _ - e 00 4+ 2+'00 - --- _ ------�- -- -- �_ - -- I 1 672 ........ REM ► ! ► TAX LOT L C"SC SILT FENCE ( OVED{ ! � I � 1 goo / 0- LLJ 18.9" PPE I I HOUSE N TO BE ! , ' °° oLLJ ! 16.7" APP E REMOVED 1) 6 / SOT � � ► 1 51 I 58QD - - - - - - - - - - - - - - - W." ow y 100 LF HALF STREET IMPROVEMENT ,--- 00 C) N TREE MITIGATION W ; • � � .................... 1 1 1 INCHES � I = 56 TREES ® 2" DIS`,. � ba I 2 INCHES fa. 16, sct I I l�L _ SCAI NOTICE; W THE PRINT OR TYPE ON ANY -r1-I j l ( � 1 1 1 1 ( 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 III III I I i I I ► ► I 1111 11 i f 1 T l I f f 1 f ( I I III III III III III ! I I ( I 1 1 I 1 1 1 1 r 1 I I ! ( ' ( ( _I I I I I I- I I I -_ - - ---- I I I I I l f 1 11 I f I I I 1 1111 11 1 V IIII111111111111 IMAGE 15 NOT AS CLEAR AS THIS NOTICE, x � � ( � , � � 1 1 1 I 1 1 1 1 11 I I I L 3 4 5 I � � IT IS DUE TO THE QUALITY OF THE 6 ORIGINAL DOCUMENT No.36 - — --- _. _ -_ - __-- – 3 11 E 6Z I SZ �. Z yZ 8Z fiZ 5' Z Z TZ 4Z 6T ST Gl 9I QI fii ETi ZT TT I [[.6 6 Iill IIII IIII IIIIiII�i,llli IIII Illi ilii IIII till I 1111 !' i Illi 1111.1.IlIlll�llllllLl IIILIIII,,,�,►gill illillli Illllill IIIIIiII IIIIIIilllll�llll IIIIl111111111111111111111111 UI1 !! lillllll I.I 1,1.11 1 11 �ll. lulll,kli W W cn c r r O c z -4 D z O D C1 13735 SW BULL MOUNTAIN ROAD - CITYOF TIGARD PLUMBING PERMIT _ DEVELOPMENT SERVICES PERMIT#: PLM2002-00118 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/11/02 SITE ADDRESS: 13735 SW BULL. MOUNTAIN RD PARCEL.: 2S109BA-01400 SUBDIVISION: HILLSHIRE SUMMIT NO.2 ZONING: R-7 W! OCK: LOT: JURISDICTION: TIG CLASS OF WORK: NEW GARBAGE DISPOSALS: MOBILE HOME SPACES: TYPE OF USE: SF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R3 FLOOR DRAINS; TRAPS: STORIES: WATER HEATERS: CATCH BASINS: _ FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 'rUB/SHOWERS: SEWER LINE: 100 ft WATER CLOSETS: WATER LINE: ft DISHWASHERS: RAIN DRAIN: 100 ft Remarks: Installation of less than 100' of sanitary sewer and less than 100'of storm sewer lines on Lot 10 of Daffodil Hill subdivision. FEES Owner: —Type By By Date Amount Receipt GEORGE MARSHALL PRMT CTR 4/11102 $110.00 27200200000 PO BOX 91249 PORTLAND, OR 97291 5PCT CTR 4/11/02 $8.80 27200200000 Total $118.80 Phone 1: Contractor: NORTHWEST EARTHMOVERS INC PO BOX 1467 TUALATIN, OR 97062 REQUIRED INSPECTIONS Phone 1: 503-624-0363 Sewer Inspection Reg#: LIC 62761 Storm Drain Ii isp Final Inspection This permit ;s issued subject to the regulations contained in the Tigard Municipal Code, State of OR. 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 requil'es you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-0001-0010 through OAR 952-0001-0080. You may obtain copies of these rules or direct questions to OUNC by calling k'503) 246-1987. �.� Istur,i By: i%1)J%c;�_—___ Permittee Signature: Call (503) 639-4175 by 7:00 P•M. for an inspection needed the next business day Plumbing Permit Application Date received: // D}- Permit P6 -� City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Hall Blvd,Tigard,OR 97223 City ajTlgard Phone: (503)639-4171 Project/appl.no.: .JXxp' a date: Fax: (503) 598-1960 Date issued: B Receipt no.: Land use approval: &)6a -j-W-/0 Case file nn.: Payment type: U I & 2 family dwelling or accessory U Com- ercial/industrial U Multi-family U Tenant improvement U New construction U Addition/alteration/repl;i enlcn( U Food service U Other: JOB SM INFORNIIATIOr4i, IULE(for special Informal t ---- -- n Inc checklist) Job address: Description Qty. Fce(ea.) Total Bldg.no.: --��— Suite no.: - New I-an(]Morally dwellings only: Taxmapltaxlot/accountno.: _ /_ r (includes 100 ft.forcachutility connection) eA tiI-R(1)bath Lot: I ejBlcr..k: Subdivision: bath �I SFR(2)ba - - - - - Proje,aname: SFR(3)bath City/county: ZIP: Each additional bath/kitchen --- Descrip.ion and location of work on premises: Siteutilities: _ Catch basin/area drain Est.date of completion/inspection: Drywells/leach line/trenchPLUMBING drain 1 Footing drain(no.lin.ft.) - Manufactured home utilities -- Business name: ,( ..�fw ,{& _ - - -- _ Manholes Address: 14f,-7 Rain drain connector City: ,-- State:• ?—ZIP; ) , _ Sanitary sewer(no.lin.ft.) /00 Phone: Fax: E-mail: Storm sewer(no.lin.ft.) /00 5' " CCB no.: -' ' ' Plumb.bus.reg.no: Water service(no.lin,ft.) City/metro lie.no.: Fixture or Item: Contractor's representative signature: Absorption valve Print name: Back flow preventer Backwater valveI it CONTACT1 Basins/lavatory _— Name: r Clothes washer — - — - Address: — - Dishwasher` - - Drinking fountain(s) City: State• -. ZIP: 7 > >2 Ejectors/surap -- - ---- Phone: Fax: - ) jL,54 I E-mail: a Expansion tank got Fixture/sewer cap Name(print): Floor drains/floor sinks/hub Mailing address: pc, — Garbage disposal -- - Hose bibb City: `� State �- ZIP: . -7Zr I Ice maker Phone: Fax: E-mail: Interceptor/grease trap -!- Owner instal lation/residential maintenance only: The actual install;cion Primer(s) --will be made by me or die maintenance and repair made by my regular Roof drain(commercial) employee on die property I own as per ORS Chapter 447. Sink(s),basin(s),lays(s) --- Owner's si mature: _ Date: Sumr-- ENGINEER — - — Tubs/shower/shower pan p,1��� Urinal Name: Addr ss: (Z� Water closet Water heater City: _ Slate:( 71P:'?7yZ= Other: — - - - Phone:5,.- Fa): E-mail: Total Not all jurisdictions accept credit cards please call Jurisdiction r«.1 inr.iun Notice:This permit application _ Minimum fee................$ _/f�_ U visa U MasterCard expires if a permit is not obtained Plar, review(at _ %) $ �-•���— Credit card number _ _ _ _�Irt1_. within 190 days ager it has been State surcharge(8%)....$ _ O "" p TOTAL . $ 719"- � accepted Ictc. •••••••••••••••••••••• rae of cardholder u shown on credo Lard P p _ _s _ Cardholder slgnou Amount 4404616(t.4l WOM) PLEAS,COMPLETE; FIXTURES (individual) Qty PNCe Iotal Fixture Type unntitv bb WorkPeriormed -- Sink - - 16.60 New I Moved Repleeed gemoved1Csppe� Lavatory 10.60 Sink -�- - ------- -- ---- Tub or Tub/Shower Comb. 16.60 Tub or Tub/Shower Combination - -- -- Shower Only 16.60 Shower Only - Water Closet 16.60 Water Closet-- - Urinal _ - Urinal 16.60 Dishwasher -M _ Dishwasher - 16.60 Garbage Disposal L aundry DisposalRoom Tray - Garbage Disposal 16.60 Washing Machine - Laundry Tray 16.60 Floor Drain/Floor Sink 2' - Washing Machine 16.60 4' - F'loor Drain/Floor Sink 2' 16.60 Water Heater 3' 16.60 Other Fixtures(Spec! 4' 16.60 y Water Heater O conversion O like kind 16.60 - Gas piping requires a separate mechanical permit. MFG Home New Water Service 46.40 - MFG Home New San/Storm Sewer 46,40 Hose Bibs 16.60 COMMENTS REGARDING ABOVE: Roof Drains 16.60 _- Drinking Fountain 16.60 - -- -b-ther Fixtures(Specify) 21.75 - Sewer-Is(100'J 55.00 Sewer-each additional 100' 46.40 Water Service-1st 100' 55.00 Water Service-each additional 200' 46.40 Storm 6 Rain Frain-1st 100' » 55.00 j Storm 6 Rain Drain-each additional 100' 46.40 Commercial RadeFlow Prevention Device 46.40 Residential BackOo%,Prevention Device' 27.55 Catch Basin 16.60 Insp,of Existinn Plu t,bing or Specially Requested 72.50 Inspectionsper/hr Rain Frain,single family dwelling 65.25 Grease Traps 16.60 QUANTITY TOTAL �y Isometric or riser diagram is required a Quantity Total Is >9 QU? n 'SUBTOTAL i, 8% SURCHARGE w "PLAN REVIEW 26%OF SUBTOTAL tF� Required only. future t total is>9 J:Ylii TOTAL ! .r . *Minimum permit fee is 572 5C*E%sum harge, ex ••l.i Reskienlial©acklkw Prevention Device,which Is!36.25+9%surcharge "All New Commercial Uulldings require plans w;th homel ir.or riser diagram and plan review BUILDING PERMIT CITY OF TIGARD PERMIT#: BUP2002-00057 DEVELOPMENT SERVICES DATE ISSUED: 2/20/02 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S109BA-01400 SITE ADDRESS: 13735 SW BULL MOUNTAIN RD SUBDIVISION: HILLSHIRE SUMMIT NO.2 ZONING: R-7 BLOCK: LOT: JURISDICTION: TIG REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION CLASS OF WORK: DEM FIRST: 2,82.5 sf N: S: E: W: TYPE OF USE: SF SECOND: sf PROJECT OPENINGS? TYPE OF CONST: sf N: S: E: AW: OCCUPANCY GRP: TOTAL AREA: 2,825.00 sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: HT: ft GARAGE: 600 sf OCCU SEP. RATED: BSMT?: MEZZ?: _ READ SETBACKS REQUIRED __ _ FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DF-T: DWELLING UNITS: FRNT: ft REAR: ft FIR ALPNI : HNDICP AC BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: Remarks: Demo 2825 sq.ft. house & 600 sq.ft. garage. Sewer to be capped & inspected, all debris to be removed. Originally in WACO, recently annexed into COT. Clean Water Svcs are still billing this site at (1) sewer& (2)s,irface I-- -- — - Owner: Contractor: GEORGE MARSHALL HEIGHTS CONSTRUCTION LLC PO BOX 91249 PO BOX 91249 PORTLAND, OR 97291 PORTLAND, OR 97291 Phone: 503-222-9158 Phune: 503-291-2550 Reg #: LIC; 133745 _ FEES REQUIRED INSPECTIONS Type By Date Amount Receipt Cap Sewer Line Insp PRMT CTR 2120102 $62.50 27200200000 Final Inspection 5PCT CTR 2120102 $500 27200200000 EROS CI R 2/20/02 $26.00 27200200000 ERPC CTR 212.0102 $8.45 27200200000 (additional fees not listed here) Total $110.40 This permit is issued sub,ect to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. 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 the rules ad pted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 9� 01- 87 YOU may obtain a copy of these rules or direct questions to OUNC by calling (503)246-6699 or 1- -332,2 Pe nnittee n Signaim e: issued By- Ca 1639-4175 by 7 p.m. for an inspection the next business day Building Permit Application /��"" Date received:, ,� �.. Permit noti./Pa,U- ' - L57 City of Tigard Projecl/appl.no.: Expire date: Ctrv(!fTigard Address: 13125 SW Hall Blvd,Tigard,OR 97223 Phone: (503) 639-4171 vete Issued: gy: Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: '34, at)C) I"C'GOC"Y 1&2 family:Simple Complex: U I &2 family dwelling or accessory U Commercial/indusinal U Multi-famil'N U New construction ,Demolition U Addition/alteration/replacement U Tenant improvement U Fire sprinkler/alann U Other: Joh address: '73S .lU, LL J ()�_ Bldg. no.: Suite no.: Lot: Block: Subdivision: Tax rnap/tax lot/account no.: - Project na rc: i-mD IL ( Ill Description and location of work on premises/special conditions:. FAWW11O A) (F loodplain,septic capacity,solar,etc.) M% FOR SPECIAL INFORM U10N, I SU ('111 ( KLIST Name:— Mail in ame:Mailin address: 12.6, Ria'K u t 24 1 &2 family dwelling: Cit State: ZIP:�j� 2. / Valuation of work................................. Phonc: 1-155'n Fax: a E-mail: c - No.of bedrooms/baths................................. Owner's representative: L)yx - Total number of floors................................. Phone: Fax: Email: New dwelling area(sq. ft.) .......................... SRL S� Garage/carport area(sq.ft.)......................... LJC) Name: Covered porch area(sq. ft.) ......................... Mailing address: Deck area(sq.ft.) ........................................ City: State:_ ZIP: Other structure area(sq. ft.)......................... Phone: Fax: E-mail C'ommerciallindustrial/multi-family: Valuation of work........................................ $ -- — Existing bldg.area(sq.ft.) .......................... _ Business name: f4_'/&0_73 C�,Js»tt(e?fo.J - �. New bldg.area(sq.ft.) Address: ) 'p Pio x q r 7-4 Number of stories........................................ City: Stalcot ZIP:C17Z� Type of construction �— Phone: - ffl-5cee" Email: Occupancy group(s): Existing: CCB no.: New: City/nrrtro lic.no.: Notice:All contractors and subcontractors are required to be licensed with the Oregon Construction Contractors Board under Name: provisions of ORS 701 Pnd may be required to be licensed in the - jurisdiction where work is being performed. II'the applicant is Address: State: ZIP: exempt from licensing,the following reason applies: City: — _ Contact person: Plan no.: Phunc; Email: Name: WI ' uAat.e lContact person: Il_C_ Fees due upon application ........................... $ Address:to SSS 5'.W, 944t. BLVID Date received: City: j 7 Z _ Amount received ......................................... $Zl — — Phone: _9c[S 3 Fax: E-mail: Please refer to fee schedule. hereby certify I have read ad e ammud this application and the Not all Jurisdictions accept credit cards,please call jurisdiction for more information attached checklist. All provis , of laws and ordinances governing this U Visa u Mastercard work will be complied wi er sI ifi herein or not. Crdn card namtm _-�—s C Expires Authorized signature Date:`2-�ZO 'O z Name or cantholder no shown un credit card S Print name: C'ardholdei signature -- Amount Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Our W 3(610 OMI a SITE WORK PERMIT CHECK LIST Commercial, Multi-Family (R-1 occupancy) and Residential: Please complete all items below, unless otherwise rioted. Excavation Volume: j __ _ cu. Yds. Grading Volume: Soils report required for>5,000 cu. ds. I cu. ds. Fill Volume: (Fill exceeding 12" in depth shall be compacted to 90% of maximum densit — - cu. yds. Retaining structure? (Check one) ❑ Rock ❑ CMU ❑ Concrete ❑ Other *Total new irrlpervious area including all buildings, sidewalks, and avin Site Utilities Plumbing Work: Complete the "TAN" Plumbing Permit Application for site utilities plumbing work. Plans Required: See "Site Work Permit Application - Plan Submittal Requirements" _attached. The following must accompapythis ap lication: Site Plan with Vicinity Map showing *Parking (including ADA) and ADA compliance Lighting Plan — Grading Plan and details *Landscaping Plan Erosion Control Plan and details Soils Report cif required Retaining Structures *Does not apply to 1 and 2-family dwellings. #of Pans TYPE OF SUBMITTAL Required at (Includes New, Additions or Alterations) Submittal Commercial 4 Multi-Family R-1 Occupancy 4 One- & Two-Family Dwelling 4 � I NOTE: Plan review is dependent upon submittal of a completed application and plans. After plan review approval, the Plans Examiner will contact the applicant to request additional sets of plans for distribution purposes (for Contractor, City of Tigard, Washington County, and Tualatin Valley Fire & Rescue). i\dsts\forms\silechecktist doc 09/24/01 SEE 35MM ROLL# 22 FOR LARGE DOCUMENT i GAR D 24-Hour ,G Inspection Line: (503)639-4175 .,v1v DIVISION Business line: (503)639-4171 MST BUP Received __ -___ Date Requested 16 r✓a Ile) __ AM ._ PM ._� BUP -7 Location 3 l 5- P, 1 I mac. Suite MEC Contact PersonPh( ) ���"�ss� PLM Contractor._---. _ -- Ph(—) SWR BUILDING Tenant/Owner _--__ _ ELC Footing ELC Foundation Access: Ftg Drain � CLQ ELR Crawl Drain Slab Inspection Notes: SIT Post&Beam __... Shear Anchors Ext Sheath/Shear Int Sheath/Shear -- --- - - -- _ Framing Insulation Drywall Nailing -- --- Firewall Fire Sprinkler - - - - - --- - - -- - Fire Alarm Susp'd Ceiling - - - Roof IV-2 PASS`PART FAIL - - - -- - - -- ING - Post& Beam Under Slab (lough-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 -- ELECTRICAL Service - — - Rough-In UG/Slab - Low Voltage Fire Alarm Final Reinspection fee of$_ required before next Ins PASS PART FAIL u — Q Inspection. Pay et City Hall, 13125 SW Hall Blvd. SITE _ Please call for reinspection RE:_ [] Unable to inspect•-no access Fire Supply Line Approach/Sidewalk Dab J fA� - Inupoctor Other: Final — DO NOT REMOVE this inspection record from the job site. PASS PART FAIL CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST BLIP --------— Received _ Date Req steel — AMIr PM BUS Location ___ 42t— -- 3 c� Suite MEC ---- — --..._ Contact Person Contractor - _ Ph ( ) SWR BUILDING Tenani/Owner ELC Footing Foundation Access. ELC Ftg Driin ELR Crawl Drain _-._- Slab Inspection Notes: SIT Post& Beam --- Shear Anchors - --- ---- --- - -- - - Ext Sheath/Shear Int Sheath/Shear Fratoin9 -- - -- - - ----- _ -..- - Insulation Drywall Nailing - --Firewall Fire Sprinkler ------ - ---- - - Fire Alarm Susp'd Ceiling -- --- - - - -_ -- Roof Other: -- Final i PASS PART_ FAIL - -.- -- PLUMBING- — Post&Beam Under Slab Rough-In Water Service Ram ra'�ins - ----- __ Catch Basin/Manholk Storm Drain ---- _ - _ Shower Pan Ot — —. in AR_T FAILk9EM - ANICAL _ Post$Beam Rough-In Gas Line Smoke Dampers Final PASS PART FAIL _ - — --- ---- - - ELECTRICAL Service Rough-In _ UG/Slab Low Voltage Fire Alarm Final ❑ Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE F] Please call for reinspection RC: -_- _._ -_ _ Unable to inspect-- no access Fire Supply Line ADA p. Approach/Sidewalk pet° a-� Z Inspector �"���t _ Ext Other:_ Find DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL 7 CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 6394175 Business Phone: 639-4171 Date Requested: f 1�-3(1 1'/;' A. _ P.M. MST: _ Location: f .7 3 r .�-�C ' fi .f'� ,��1�i` c ��j BUP: Tetuutt Suite: Bldg: —� NEC: — .. Contractor:_ Phone: PLM: Owner:�rx { _Phone: r ELC } --�._ sm _ BUILDING —BLDG(can't) PLUMBING "MFCFIANIC-AL,–- ZLECTRICAL SITE Site Post/13cam Post/Beam Post/l;cam Cover/Service Sewet/Stone looting Roof Undl'I/Slab Rough-[n Ceiling Water Line Slab Framing 'fop Out (;as bine Roi:gh-In 14;Sprinkler FounGation Insulation Sewer I100d/lila !:ccunnect Vault 13smt Dmil) Drywall Stonn I'mace Temp Service MISC. Masons Ceiling Rain Thain A/C UG Slab Shear/Sheath lire Spklr/Alm Crawl/l-'ound Or I feat Pump Low Volt Approved Approved! Approved Approved Approved APer/Rd�ti14 Not Approved N 4 Approved o oved Not Approved Not Approved FINAL FINAL, FINAL FINAL FINAL 1 0 Call fur reinspect' n CI Reinspection fee of S required before nett inspection 0 Unable to inspect inspector ._�C e i�te: ^y Page of y CITY OF TIGARD MECHANICAL DEVELOPMENT SERVICES PFRMIT 13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . : MEC97--0382 DATE ISSUED: 10/06/97 PARCEL: 2S 1.09BA-01400 SITE ADDRESS. . . : 13735 SW BULL MOUNTAIN RD '.SUBDIVISION. . . . : HILLSHIRE SUMMIT NO. 2- ZONING% R--; FLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: URB CLASS OF WORN,. . :ALT FLOOR TURN. . . . : 0 EVAR COOLERS: 0 TYPE OF USE. . . . :SF UNJT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY GRP. . :R3 VENTS W/O APRL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL. TYPES------------- 0-3 HP. . . . : 0 DOMES. I NC T N: 0 3-1 51 HP. . . . : 0 COMML. I NC I N: 0 IMAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 F IRE DAMPERS?. . 30-50 HP. . . . : 0 WOODSTOV'.-5. . : 0 GAS PRESSURE. . 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS---------- AIR HANDL. ING UNITS OTHER UNITS. : 0 TURN ( 100K BTU: 1 (-- 1.0000 cf m : 1 GAS OUTLETS. : 0 FURN ) =100K BTU: 0 i 10000 rfm: 0 Remarks : In.tall a new oil furnace and an air conditioning unit for an existing single family dwelling. Air conditioning units cannot be placed inside the required setback areas Owner: --------------------------------------------------------- FEES - ZEDNIK, MARY R LEAH type amolsnt by date rer_:pt 13735 SW BULL. MOUNTAIN ROAD PRMT $ 25. 00 GEO 1.0/06/97 97-299820 IIGARDO OR 97224 5PCT $ 1. 25 GEO 10/06/97 97-299820 Phone #: 590-1569 I Contractor: FIRST CALL_ MCCALI_ HEATING R COOLING _____------•--_________------.----.-----------___ 1650 NE LOMBARD f 26. 25 TOTAL_ PORTLAND OR 97211--4798 Phone #: 231-3311 Reg #- . : 001020 - ---- - - REQUIRED INSPECTIONS This permit is Issued subject to the regulations contained in the Mechanical Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Insp applicable laws. All work will be done in accordance with C n o 1 i n g Unt Insp approved plans. This permit will expire if work is not started Misc. Inspection _ within 180 days of issuance, or if work is suspended for more Final Inspection than 18@ days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-NI-NIO through OAR 952-@@l-@e8@. You may obtain copies of these rules or direct questions to OLK by calling f ss 1_I e By _ _ Permittee ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++.++++++•+++++++++ F,7-9-41 7C hV &—L711A W m_ fnr i ncper4inns need aH tha nip at h I I L in a a C jam_ +++++++++++f++ + + +' f + + } + ++++r+++++++++++++++++++++++++++++44+++ ++-1-++ f+ F ++F+++t++ Plan Check# CITY OF TIGARD Mechanical Permit Application RBed By_ i 13925 SW HALL BLVD. Commercial and Residential � Date Recd TIGARD, OR 97223 Date to P E. (503) 639-4171, x304 Date to DST Print or Type Permit Incomplete or ille 1ble applications will not be accepted Called Nams of DevetopmenWrotsc! Mscriplion Table to Mechanical Code QTY PPiCE AMT Job Street Address Sueea A) Permit Fee -0 -0- 10.00 Address l3-13.5 ea- Bidge crtyrstate Zip 1.) Furnace to 100,000 BTU 6.00 _ \ including ducts 3 vents Name for name of business) 2.) Furnace 100.000 BTU+ 7.50 Owner 01 (r I .2 Z ��v� s!C inciuding duds a vents `]C Mailing Address 3.) Floor Furnace 6.00 U\` ►Ylt (LCA inchicling vent Crtyrstate ZipPhone 4) Suspended healer,wall heater 6.00 -V\-(- , h }'1 12 s etc vcld or floor mounted neater _ Name( nam*of business) 5.) Vent not included in appliance permit -4.00 Occupant Mailing Address 6) Boiler or comp,heat pump,air Gond 6.00 to 3 HP;absorb unit to 100K BUT" city/stale Zip I hone 7.) Boiler or comp,heat pump,air Gond. 11.00 3-15 HP;absorb unit to 5WK BTU" Contractor tNt,,R1 Name 8.) Boiler or comp,heat pump,air Gond. 15.00 (Prior to 111 r e�1 4 C C(t 1 1 15-30 HP;absorb und.5-1 and BTU" issuancerpling Address I 9) Boiler or comp,heat pump,air Gond. 22.50 4 applicant `Ic) L' N l U r-r\0 ct 'c t 30-50 HP;absorb unit 1-1.75mil BTU" must provide all itWslatt; zip Phone 10) Boiler or comp,heat pump,air Gond. "'o contractor (• CIL-)7_\\ .?9 '� 1`i \` >50 HP;absorb unit 1.75 mtl BTU" license Oregon Const.Cont.Board Lic d Exp DWe 11 ) Air handling unit to 10,000 CFM 4.50 information if expired in lc COT COT BuaMaTax aMetru0 Exp Date 12.) Air handling unit 10,000 CFM 7,50 database). 11i(.,-) C.1 \l -11-1 Amhitect NeR1e 13.) Non-portable evapc ate cooler 450 or Mailing Address 14) Vent tan connected to a single duct 3.00 Engineer Ctp5tate ZipPhone 15) Ventilation system not included in 450_ appliance permit _ Des( work New O AdditionW Alteration U Repair O 16) Hood served by mechanical exhaust 45J to be done Residential O Non-residential O Additional Description of work 17.) Domestic incinerators 750 \ rl rk \ a 1 ct C, 18) Commercial or industrial type _ 3000 Incinerator Fxisting use of 19) Ripair units 450 building or prop." 20) Wood stove 4.50 Proposed use of 2.1 ) Clothes dryer,etc. 4.50 building or property 22) Other units 450 Type of ;; �atural gas 0 LPC,O electric O 23) Gas piping one to four outlets 200 I hereby acknowledge that I have read this application.that the 24) Mcm than 4-per outlets(each) 50 information given is correct,that f am the owner or authorized agent of the owner.that plans submitted are in compliance with Oregon State _ CITY SUBTOTAL laws L� Sigj Owner/Agent Date *SUBTOTAL n � CA 5%SURCHARGE l 1 Goon Name Phone PLAN REVIEW 25%OF SUBTOTAL E� 9�- (qLA C9 TOTAL _i i\dstVnechpmt doc (rev 9 / Minimum permit fee is S25—+5%surcharge '� V(eKo "Residential A/C requires site plan showing placement of unit. RECEIVED OCT P 6 1997 COMMUNITY OFMOPMENl Jot) Site Plan / l I ` l I Additional Instructions: - - _ --- - --- Refrigeration line size _ ` — - — �u Condensate Pump ❑ �'�' No LI BOX New egiste New Grills ❑Vibration Pads Acid Return Du.: Add Supply Duct ---- tl- -L , Special needs --