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11380 SW GREENBURG ROAD I w m u w F., LTJ [TJ z w c 0 h t i r —' 11380 SW GREENBURG ROAD CITY OF TIGARD MECHANICAL DEVELOPMENT SERVICESPERMIT MEC96-0426 13125 SW Hall Blvd., Tigard,OP 97223 (503)639-4171 PERMIT #. . . . . . . : DATE ISSUED: 12/10/96 PARCEL: IS135CA-01'.200 SITE ADDRESS. . . : 11,38qi SW GREENSURG RD SUBDIVISION. . . . : ZONING: R-12 BLOCK. . . . . . . . . . : I.-OT. . . . . . . . . . . . . .. ------------------------------------------------- CI-ASS OF WORK. . :ALT* FLOOR t"'URN. . . . : 0 EYAP COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANCY ORP. . :R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . . 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL 0-3 HP. . . . 0 DOMES. INCIN: 0 : /GAS/ 3-15 HP. . . . 0 COMML. INCIN: 0 MAX INPUT 0 BTU 15--30 HP. . . . 0 REP;)IR UNITSt 0 FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0 GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS----------- AIR HANDLING UNITS OTHER UNITS. : 0 F URN i 11710K BTU: I (= 10000 cfm : 0 GAS OUTLETS. FURN ) =IIAOK BTU: 0 > 10000 cfhl: rA Hemav,l.(s : Installing fl.-lir-nace to 100, 000 BTU' s and gas piping Owner- F[7 ES RAYMON MACY type amount by date v-ecpt 11380 SW GREENBURG RD PRMT $ 25. 00 B 12/10/96 96-287507 5PCT $ 1. 25 B 12/ 10/96 96-287507 T'IGARD OR 97�23 11hone #i 968•• 1 '114 oilt t,act nir-: OWNER ------------------------------------- Phone $ 26. 25 TOTAL r7pq #. . : 13125 REQUIRED INSPECTIONr, This nervit is issued subject to the regulations contained in the Gas Line Insp ------- Tigard Municipal Code, State of are. Specialty Codes and all other Mechanical Insp applicable laws. All work will be done in accordance with Final Inspection approved plans. This persit will expire if work is not started within IA days of issuance, or if work is suspended far sort than IN o3YS. Psi-mittee S, n&t1JT`e ."( 1,k Issued By . Call for inspection 639-4175 Plan Chacktn CITY OF TIGARD Mechanical Permit Application F .c'd By;� � . �� 13125 SW HALL BLVD. Commercial and Residential Cate Recd % � 'f TIGARD, OR 97223 Oate to P E. (1503) ' 39-4171, x304 Date to DGT Print or Type PE' Called _ Incomplete or illegible_ applications will not be accepted _ Name of DevelupmenvPmiect ,tet Description A-i-1:Lit c , Table 1A Mechanical Code OTv PNCE ANIT Jot) street Aaaress sunea �A) Permit Fee —` ---III Address =+ � c' 1 �` � �j4ic' '� .0- -0- 10 00 1 k 7�t E,J Bid M ''—c tylslate fZip B) Supplemental Permit 300 Name,or name of businessi 1 1 Furnace to 100 000 9TU F)00 Owner I-11i MAIM A) 144 cit-/ i,lcl ducts&vents nfa ng a tlrosa 1n y1 21 Furnace 100,000 BTU+ 7:7 07 (I lC1 k'tc' rl' K r{ ocl ucts&vents Gry State Zip Phone 3) Floor Furnace _ .-- 6 OQ �' incl vent Name nems of til nese) 4) „1.ispended heater,wall heater 600 or floor mounted heater Mamng n resp7� S.) Vent not incl.in 3.00 Occupant 1 _ appliance permit Crtystule zip Phone' 6.) Boiler or comp,heat pump,air tend. 6.00 to 3 HP,absorp unit to 100K BTU I / 7) Boiler or comp,heat pump.air Gond. 11 00 L Y1 p )L) l c r-t 3-15 HP,absorp unit to 500K BTU Contractor Mating address 8.) Boder or comp,heat pump,air Gond 15.00 15.30 HP,absorp unit 5-1 and BTU (Prior toC tyrslme zip Phone 9) Boiler or comp,heat pump.air Gond. 22.50 issuance a copy 30-50 HP;absorp unit 1-1.75 r .I BTU M all licenses are Orogen Const C0411 Board Lc r Exp.Date^ 10.1 !oiler or comp,litzt pump,air wnd 3750 required if >50 HP,absorp unit 1.75 and BTU expired in C O T CCT Business i ano�Mew a Exp Dne 1; ) Air handling unit to i 4 50 data base) _ 10,000 CFM_ Architect Name --- 12 1 Air handling unit 7 50 10,000 CTM+ Or Mating ndtlress 13.) Non portable �Y 450 evaporate cc�!dr Engineer Cnytstale _ rip Phone 14) Veit fan connected _ 3,00 to_a single duct Descnbe work New O AdIrtion 6 Alteration O Repair O 15) Ventiiabon systemnot 4 50 to be done _Resx,ential O Non-residential O included in appliance permit Additional Description of work 16) Hood served by mechanical exhaust 450 l T A1 "I/Ill /�._ "N/Al'*1. 17) Domestic incinerators _ 750 Existing use of 18) Commercial or ndustnaltype 3000 bwlding or property 19) Repair units _ 430 Proposed ise of 20) V.00dstove 450 hu,'dfng or property ____ 21) Clothes dryer,etc. _ 4 50 _ Type of fuel-utl O natural gas LPG 7 efectnc O 22) Other units �^ _ 450 I hereby acknowledge that I have read this application,that the 231 Gas piping one to four outlets 200 information givens correct that I am the owner or authenzed agent of the uwn1r,that plans submitted ark in compliance with O gon 'tate 24) More than 4-per outlet (each) 50 /laws 1 _L Z t. 1 C l 2/t v Signature o er/Agent ate OTY.SUBTOTAL // 4 Contact erson Narniii Phone 5%SURCHARGE PLAN REVIEW 25%OF SUB TOTAL TOTAL - i`dst\mechpmt aoc tri.v 7/96) Minimum permit fee is S25+5%surcharge CITY OF TIGARD BUILDING INSPECTION NOT199 Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service N Foundation Water Line Ceiling -Plumb. Post/Beam Mech. Shear/Sheath Framing Mech Plbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line Appr/Sdwlk Reins. Other: ���.- ---- Date: _ ` L_L��.___ A.M. P.M Entry:_ Address: --- Tenant: -- - -- Ste:----_ Sl: - — - — _- BU P. Con/Own: __ —___ .-- —._ ML PLM: ELC: THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR: Inspector - --- ------ mate: —APPROVED __—DISAPPROVED/CALL FOR REINS P. CF CO CITY OF TIGARD _ PLUMBING PERMIT DEVELOPMENT SERVICES PERMIT#: P 17/03 00090 DATE i3SUED: 311703 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 1 S 135CA-01200 SITE ADDRESS: 11380 SW GREENBURG RD ZONING: R-12 SUBDIVISION: BLOCK: LOT: — JURISDICTION: TIG CLASS OF WORK: REP GARBAGE DISPOSALS: MOBILE HOME" SPACES: TYPE OF USE: MF WASHING MACH: BACKFLOW PREVNTRS: OCCUPANCY GRP: R1 FLOOR DRAINS: TRAPS: STORIES: WATER HEATERS: CATCH BASINS: FIXTURES LAUNDRY TRAYS: SF RAIN DRAINS: SINKS: URINALS: GREASE TRAPS: LAVATORIES: OTHER FIXTURES: 1 UBISHOWEP.S: SEWER !_INE: ft WATER CLOSETS: WATER LINE: 200 ft DISHWASHERS: RAIN DRAIN: ft Remarks: Repair 200'of water service. — ---- FEES Owner: _ ---- Description Date Amount MACY, RAYMON 111LUM131 i'Cimil I cr 3/17/03 $101.4C 11380 SW GREENBURG RD rn�1 ti°„ , I., 3/17/03 $8.12 TIGARD, OR 97223 — � --- Total _ $109.52 Phone Contractor: _ PREMIER PLUMBING 20 SW 131 ST AVE BEAVERTON OR 97005 REQUIRED INSPECTIONS Water Service Insp Phone : 503-469-4631 Final Inspection Reg #: 11(' 124547 III %1 34-3 181`13 This permit is 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 fcr more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Issued By: t/ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for an inspection needed the next bus ss day Building Fixtures FOR Phumhing Permit .� r. lication Received ' I'wmbing Date/By Cl.'r Permit No.: CHAI- F Aly L� 1 ;:11 dPlanning A prova Sewer City Uf Date/By:: Permit No.: 13125 SW I I ill Blvd Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-41'11 Fax: 503-598-1960 Post-Review Land Use Datc/13 : Case No.: Internet: www.ci.tigard.or.us Convect Juris.: see Page 2 for 24-hour Inspection Request: 503-639-4175 Nam./Method. su Iemental Information. TYPE OF WORK FEE*SCHEDULE(for special information use checklist New construction _y e_molition Description Qty. Fectca.l rr�tal Addition/alteration/re lacementOther: New 1-&2-family dwellings CATEGORY OF CONSTR CT10N Includes 100 ft.for each utIII(Z connection I &2-Familydwellin Commercial/Industrial SFR I bath 249.20 __�_ _- SFR 2 bath 350.00 Accessory Building Multi-Family SFR 3 bath _ 399.00 Master Builder M Other: Each additional bath/kitchen _ 45.00 JOB SITE INFORMATION and LOCATION Fires rinklci -sq. fl.: Pae 2 Job site address: Grr Site Utilities Suite#: Bldg./Apt.#: Catch 11/lea h line/trench drain 16.60 Dr ell/leach line/trench drain _ 16.60 Project Name: _-- Footing drain no.linear R. _ Pae 2 _ Cross street/Directions to job site: Manufactured home utilities 110.00 Manholes 16.60 _ Rain drain connector 16.60 Sanitary sewer no. linear R. Pae 2 Subdivision: Lot r.. _ _ Storm sewer no.linear fl. Pge2 Water service(no.linear RZ l" i Page 2 Tax ma / arcel#: Fixture or Item DESCRIP'T'ION QF WORK Absorption valve 16.60 Backflow prevcnter _ Pae 2 Backwater valve 16.60 -- Clothes washer 16.60 - -- - Dishw..sher 16.60 Drinking fountain 1660 ROPER'1'Y OWNERTEN NNT •- Ejectors/sump 16.60 Name: ; ^- , 5�Q Expansion tank 16.60 Address: )( ?,r� /tc�lwX � ' Fixture/sewer ca 16.60 C /State/Zt�- Q `� Floor drain/floor sink/hub 16.60 lt Y P'_FkQ -2�------- Garbage disposal _ 16.60 Phone: r' Hose bib 16.60 APPLICA14T ON CT PERSON L Ice maker 16.60 Name: tr ( rr' #V%_ lnterce tor/ rease trap16.60 Address: edical as-value: 5 Page 2 rimer 16.60 City/state/z, Roof drain commercial 16.60 _ Phone Fax /5 Sink/basin/luvato 16.60 E-mail: Tub/shower/shower an 16.60 CONTRACTOR Urinal 16.60 Business Name: Y Water closet 16.60 1 Water heater 16.60 _ Address: Inj Other: Cit /State/Zi Y Other: Phon00V -� Plumbic Permit Fees* ' 3 Q - CCB L1C. L Fl nib. Lic.#: Subtotal 5 Minimum Permit Fee$72.50 $ Authrriz �I Residential Backflow Minimum Fee$36.25 Signatu 1� ate:._ l Q 3 Plan Review 25%of Permit Fee 5 h1_LY"l State Surcharge 8%of Permit Fee) 5 i IT (Please Illnae) TOTAL PERMIT FEE 5 r im Notice: This permit application expi s if a permit Is not obtained within All new commercial buildings require 2 sets of plans with Isometric or 11110 days after It has been accepted a%complete. riser diagram for plan review. *Fee methodology set by 7A.County Building hdusnl,Service Board. is\Dsts\Permit Forms0mectmitApp.doc 01103 Plumbine Permit Application - City of Tigard Page 2 - Supplemental Information ' Fee Schedule: Residential Fire Suppressio Sy terns. Site Utilities Qty. Fee(ea) Total Square Foota e: Permit Fee: Footing drain-1"100' 55.00 0 to 2,000 _ $115.00 Footing drain-each additional 100' 46.40 2,001 to 3,600 _ $160.00 _ 3,601 to 7,200 $220.00 Sewer- Ist 100' 55.00 7,201 and greater $309.00 Sewer-cacti additional 100' 46.40 Water Service-Ist 100' 55.00 Medical Gas S stCmS' Water Service-each additional 100' 46.40 Valuation: Permit Fee: f Storm&Rain train-Ist 100' 55.00 $1.00 to$5 000.00 Minimum fee$72.50 Storm&Rain Drain-each additional 100' 46.40 $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for each Total additional$100.00 or fraction thereof,to and Fixture or Item Qty. Fee(ea) including$10,000.00. Commercial Back Flow Prevention Device 46.40 $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for Residential Backflow Prevention Device each additional$100.00 or fraction thereof,to minimum permit fee$36.25 27.55 and including$25,000-00. Rain Drain,single family dwelling 65.25 $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for each additional$10 .00 or fraction thereof,to Inspection of existing plumbing or and includins$50,000.00. specially requested ins ctions•per hour 72.50 $50,001.00 end up $742.00 for the first$50,000.00 and$1.20 for Subtotal: r each additional$100.00 or fraction thereof. r i Fixture Work: Are you capping,moving or replacing existing fixtures? If "yes",please indicate work performed by fixture. Failure to accurate) 'report fixtures could result in increased sewer fees*. Quantity b FixVuc Work Performed I Comments regarding fixture work: Fixture Type: Replace _ New Moved Existing Capped -- Ita tisal I unt _ 9 ►.lath -Tub/Shower Jacuzzi/Whirlpool _ Car Wash -Each Stall - ---- - -Drive Thru Cus idor/Watcr Aspirator Dishwasher •'.'ommerci:d _ __ -• -- -Domestic _ Drinking Fountain Eye Wash Floor Drain/sink 2" .4" Car Wash Drain *Note: If the fixture work under this permit results in an Garbage -Domestic - increase of sewer EDI Js,a sewer permit wil' .re issued and Disposal -Commercial -industrial fees assessed for the sewer increase mutt be paid before the Ice Mach./Reffig [rains plumbing permit can be issued. Oil Separator (las Station Rec•Vehicle Dump Station - Shower -Gang -stall _ Sink -Bar/Lavatory -Bradley -Commercial -Service Swimming Pool Filter Washer•Clothes Water Extractor Water Closet-Tcilet _ Urinal Other Fixtures: i:tDlstsU'ermit FotmslPlmPerrmtAppPg2.doc 01103 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 INSPECTION DIVISION Business Line: (503)639-4171 MST — BUP Received Date Re uested___-.3 _ AM_. PM BUP __— Location _--� � ____ Suite MEC _ Contact Person Ph(_--._) "_ _ PLM aoo 9D Contractor Ph(__—_—) oZ� p�� SWR BUILDING_ Tenant/Owner _ ELC Footing a ELC Foundation Access: Ftg Drain 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 Other: Final PASS PART FAIL PLUMBING "' 'Z�_,� -----«��i'" �/r •' Post&Beam Under Slab - -- Rough-In ervi — arntary Sewer Rain Drains - Cetch Basin/Manhole Storm Drain Shower Pan Oth Final — PASSi T FAIL -- - — *A�-C1`I Post&Be 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 PAPT FAIL SITE Please call for reinspection RE:_ -- Unet•,e to inspect-no access Fire Supply Line ADA r% Approach/Sidewalk Data. _ EX-1_— Other: Final DO NOT REMOVE this Inspetatlo record from the fob she. PASS PART FAIL