11930 SW GREENBURG ROAD Lo
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--41930 SW GREENRURG RDS STE 200 —
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
t
rooting Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling CPTumb,
Post/Beam Mach. Shear/Sheath Framing -Mech.
Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mach, Rough-in Gyp. Bd. -Bldg,
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: �3��_ A.M. �P.M. Entry: _
,Address: -2)U_-._
Tenant:` Ste�d MS
Z Z (� --
Con/Own ✓c 3 HUP:r � MEG
PLM: .-Z7-
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR:
Inspector _^ _ Date:
V,�APPROVED DISAPPROVE')/CALL FOR REINSP. CF CO
CITY OF TIGARD BUII GING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 6394171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech, Shear/Sheath Framing -Meth.
Plbg.Und/Fir/Slab Plbg. Top Out Insulationect
Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: _ A.M. P.M.__ ntry:
Address: U
Tenant: _ Ste: ' MST
BLIP
Con/Own:_ i _ MEC _
PLM'
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
41l
Insp®ctor �,t ._ `7� Date: r•Z"
APPROVED ___DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL
Foundation Water Line CEiling -Plumb.
Post/Beam Mech. SheariSheath Framing ec
Plbg.Und/Fir/Slab Plbg.Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-In Gyp. Bd. _iii a
San. Sewer Gas Line Appr/Sdwlk I(G�1
Other: I I --------- -- --- -
Date: 4 A.M. —P.M._ Entry:
Address:
Tenant: Ste4Z;24_) 9ST �r `—
BLIP:
�o /Own:Ji 3 MEC:��''
PLM: -_
r%O C/ 7' ( S S 7 ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
i
Inspector: — -Date CS-
OPROVED _ DISAPPROVED/CALL FOR REINSP CF
CITY OF TIGARD
DEVELOPMENT SERVICES
1 13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
CERTIFICATE OF
0(-CUPANCY
PERMIT #. . . . . . . s SUP96 -0568
DATE I,-,)SUEDi
PARCEL- IS1351)D-04400
HDOPE.55. . . t11930 SW GREENSURG RD #200
IVID I V I SI ON. . . . z 7 ON I NG#C--P
ul . . . . . . . . . . L.OT. . . . . . . . . . . . . JURISDICTION: TIG
ASS OF WORK. -ALT
,PE OF Uc3E. . . gC(.301
,'PIF OF CONGTRA5N
''(2CLIPANCY GRP. :P
OL"CUPANLY LOAD: 4
TLNANT NAME , . . -MIKE 61E.VENSON
Refflay,kfiss lenant jmpv-ovement
owner:
11TRE, STEVENSON
,.,s25 r)ELLWOOD DR
LAKE OSWEGO OR 97IB35
VAholle #1
C0ntY'aLt0V-t
MICHAEL Mf,i ONLY
17511 HILL. WAY
t.rwE oswEou Op wo35
Phone 697- A857
Rett 097L145
this, Cet-tifAcate pt-ants oc.ct.1pancy of the above refPrenced building or- J),:''
theveof and confit-ms that the bmidiny has been in%pacted for compliance will
the State of Ot-4011 specjellyCode; for' the group, 0'x-up1Ar1(-V end kite under,
which the rRfevenued permit was is-iue(j.
'
B 1i I L. NG IN"41 14 "�F FS7,TOP
RUILDI OFF I
POST IN CONSPICUnUS PLACE
171
t% CITY OF TIGARD BUILDING INSPECTION NOTICE —
Inspec'ion Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mech. Shear/Sheath Framing ec
' Plbg.Und/FL/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mech. Rough-in Gyp. Bd.
San. Sewer Gas Line Appr/Sdwlk ROD
Other:
Date: _I-- A.M P.M. Entry:
I'.ddress:
Tenant: IGIST
B Up
o /Own _ 1G . ` Z Z�-------- ---- - MEC
EC
:_
ELC: -- —
THE FOLLOWING CORRECTIONS ARE REQUIRED ELR:
APP110VEL" -
i;1TY O[; I'T(;ARll — ------ ------
ilv..
Tit
pr
----
-- ----.--_--------
Inspector , _---- --_--_ _ Date
d. PROVED _DISAPPROVED/CALL FOR REINSP. _ CF
f'
1
CITY OF TIGA►RD
DEVELOPMENT SERVICES BUILDING PERMIT
13125 SIN Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . . BUP96--0568
DATE ISSUED: 11/12/96
PARCEL: IS135DD-04400
_iITE. ADDRESS. . . : 11930 SW GREENBURG RD
SUBDIVISION. . . . : ZONING:C--P
BLOCK. . . . . . . . . . .. LOT. . . . . . . . . . . . .
REISSUE: FLOOR EXTERIOR WALL CONSTRUCTION—
CLASS OF WORK. :ALT FIRST. . . . 0 5f Ne S: E: W:
TYPE OF USE. . . :COM SECOND. . . . 0 s PROTECT OPENINGS?-----------
TYPE OF CONST. :5N
0 sf Ne S: E.- W.-
OCCUPANCY GRP. .-B TOTAL----- : 0 sf ROOF CONST: FIRE RET? :
OCCUPANCY LOAD: 0 BASEMENT. : 0 sf AREA SEP. RATED:
STOR. : I HT: 0 ft GARAGE. . . : 0 sf OCCU SEP. RATED:
BSMT?: MEZZ?: REOD SETBACKS-------- REQUIRED---------------------
FLOOR LOAD. . . . : 0 psF LEFT: 0 ft RGHT: 0 ft FIR SPKL:N SMOK DET. . %N
DWELLING UNITS: 0 FRNT: 0 ft REAR: 0 ft FIR ALRM:N HNDICP ACCtY
BEDRMS: 0 BATHS: 0 IMP SURFACE: 0 PRO CORRIN PARKING: 0
VALUE. $: 11500
Remarks : Tenant improvement
Owner-: ------------------------------------------------------- FEES ---------------
MIKE STEVENSON type amount by date r,ecpt
2825 DELI.-WOOD DR PRMT $ 92. 50 B 10/31/96 96-285959
PI-CK f 60. 13 B 10/31/96 96-285959
I-AKE OSWEGO OR 97035 FIRE $ 37. 00 B 10/31/96 96-285959
Phone #: 639-9835 5PCT $ 4. 63 B 10/31/96 96-285959
Contractor-: -----.------------_--__.-------__.--.
MICHAEL MALONEY
17511 HILL WAY
LAKE OSWEGO OR 97035 ----------------------------------
Phone #: 697-1857 $ 194. 26 TOTAL
Reg #. . s 09784ti
REQUIRED INSPECTTONS
This permit is issued subject to the regulations conta)npd in the Framing Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Gyp Board Insp
applicable lasts. All work still be done in accordance with Susp Cellng Insp
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for tire
than IW days.
Pey,mittee Sit ut-e :
Issued By :
Call for inspection - 639-4175
MAI
Q n P m it-Aoolir • t� h
City of Tigard 131.:5 SW Hail Blvd. Tigard,OR 97223 J
503►639-4171
Jobsite Address: 19 �(C:' SI'U 6'2enahu6y /r'l) OFFICE USEEQNs,Y
Tenant: '�'_"L- Alls,rSC.q Suite Planck/Ree. #
Valuation: L _ Permit#
Map &TL#-l j i`,P
Owner:
Annrova�Reaui�
,address: RLq�aZ S Oc�C( c�, r�c� /c' ��
Planning
1-14�(c� CJs„��o c��r �'7��3 s �_.. .
Telephone: .3 ,j S -----
/� G _ Engineering
_ (.L� 7 c�' ._
Other
Contractor: JzPI4 c_onc Y
Address: 2-� 8 HI t e
1 S7 cj& 0 &if f70-3 S� Type of eonstr:
Telephone: -7 Occupancy Class:
Contractor's License # (!?c ' Sprinkler? Yes (No,)
(attach copy of current Oregon license)
Iii j, r,r Irl t,.� Sq. Ft. Of Project:
Contact name & teiephone: C�IcJCe •
Architect R Engineer: ftfYhf 4t o011/� 3� 3 a� 41 Story (1st, 2nd, etc.):___
- /i
Proposed Use: _ 6pwm-e
Address:
Previous use: C-(/lI'kI-Lf.-tcf
Note: Plumbing & mechanical pians must
Telephone: be submitted at time of building permit
application.
JOB DESCRIPTION: -,Kt �fi ��t y.w+,'o�► 9C"(1 r �/Lu �CL�c
1 S�A
/� 1
(Applicant 3ignatu Telephone Number)
Received by: Date Received:
PERMIT# Account Description Amount
Amt Pd. Balance Due
Building Permit (BUILD) "
Plumbing Permit (PLUMB)
` Mecnanical Permit (MECH)
State Tax (TAX)
Bldg.
Plumb. _
Mech.
Plan Check (PLANCK)
Bldg.
Plumb.
Mech.
Sewer Connection (SWUSA)
Sewer Inspection (SWINSP)
Parks Dev Charge (PKSDC)
Rcsidential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C)
Industrial TIF (TIF-1)
Institutional TIF (TIF-IS)
Office TIF ITIF-O)
Water Quality (WQUAL)
Water Quanity (WQUANT)
Fire Life Safety (FLS) �7 7
Frosion Cntrl Permit (FRPRMT)
Erosion Planck/USA (ERPLAN)
Erosion Ptanck/COT (EROSN)
TOTALS:
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 PERMIT #: ELC96-0746
DATE ISSUED: 11 /21/96
PARCEL: IS135DD-04400
SITE ADDRESS. . . : 1. 1930 SW GREENSURG RD #200
SUBDIVISION. . . . .- ZONING:C-P
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . :
Project Description: Tenant improvement : Mike Stevenson
-----------------------------
RESIDENTIAL UNIT---- ---TEMP SRVC/FEEDERS-.----- ------MISCELL.ANEOUS----.
SF OR LESS. . . . : 0 0 - 12100 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : it
EACH ADDIL 500SF. . . : 0 201 - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0
LIMITED ENERGY. . . . . : 0 401. - 600 amp. . . . . . . : 0 SIGNAL/PANEL. . . . . . . : 0
MANF. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL (10) . . . : 0
- ---SERVJCE/FEEDER---- -,----BRANCH CIRCUITS----- ----ADD' I- INSPECTIONS-
0 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . ; 0
201. 400 amp. . . . . . : 0 1st W/O 8RVC OR FDR. : I PER HOUR. . . . . . . . . . . : 0
401 600 amp. . . . . . : 0 EA ADDIL BRNCH CIRC: 4 IN PLANT. . . . . . . . . . . : 0
601 1000 amp. . . . . . 0 REVIEW SECTION--------------
1000+ amp/volt. . . . . : 0 ) -4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Rti,connect only. . . . . t 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. :
Owner: ------------------------------------------------------ FEES
MIKE STEVENSON t"'pe allol-iint by date recpt
2825 DELLWOOD DR PRMT $ 55. 00 JSD 11/21/96 96-286832
9PCT $ 2. 75 JSD 11/21/916
LAKE OSWEGO OR 97035
Phone #j 639-9835
Contractor: ---------------------------------------------------------------------------
GARNER ELECTRIC $ 57. 75 TOTAL
21785 6W TV HWY
#L ------- REQUIRED INSPECTIONS
ALOHA OR 97006 Ceiling Cover Elect' l Final
Phone #: Wall Cover
Reg #. . : 11.6721
This pirsit is issued subject to the regulations contained in the
Tigard Municipal Code, State of Ore. Specialty Codes and all other i;. e v ..;1yi at lAre
die 1 El I�;tLl r I
applicable laws, All work will be done in accordance with
approved plans. This perut will expire if work is not started
within 140 days of issuance, or if work is suspended for eore
than A0 days. 1sued By,
._-_--_____________________.__OWNER I NSTAI-LAT 104'ONLY.---
The installal' on is being made an property I own which is not intended for
sale, lease, or rent.
OWNER' S SIGNATURE: DATE:
INSTALLATION
SIGNATURE OF SUPR. ELEC' Ni DATE-
LICENSE NO:
Call for inspection 639-4175
CITY OF TIGARD Electrical Permit Applications Plan Check If
13125 SW HALL BLVD. Recd By
i
TIGARD OR 9722.3 Date RecdDate to P.E.
Phone(503)639-4171, x304 Print or Type Date to DST _
Inspection (503) 639-4175 I Incomplete or illegible will not be accepted Permit a .
Fax(503)684-7297 Called
1. Job Address: B � G1' �.�uf�h Y l 4. Complete Fee Schedule below:
Name of Development__4LI��__s`u , Number of Inspections per permit allowed -
Name(or name of business)/11rk,� eM4, cowsT_ Service included: Items Cost Sum
Address-AIT 36) 9 lJ / rCJ, 4a. Residential-per unit
CI /S /Zi _"n4 1000 sq.f1.or 1-,ss -_-- $+moo
tytatep � _ Each additioral 500 sq.It.or
Commercial'^ Residential E] Limited
thereof $25 00 t
Limited Energy $FIs nn
Each Manuf'd Home or Modular
D
2a. Contractor installation Only: welling Service or Feeder $68.00
(Attach copy of a urrent IIcerise 4b.Services or Feeders
Electrical 'ontractor Y Installation,alteration,or relocation
Addresss 200 amps or less $60.00 _
201 amps to 400 amps $60.00
City 411C _ t5 ate __ -Zip_ ___ 401 amps to 600 amps $120.00
Phone NC')'. ��- ��-- 601 amps to 1000 amps � $100.00 � 2
Job No. Over 1000 amps or volts $340.00 2
Elec.Cont, Lice. No. _ Exp.Date1 Reconnect only $50.00
OR State CCB Reg. No.Q1.1X-1 _Exp.Date &-/ -Q� 4c.Temporary Services or Feeders
COT Business Tax or Metro"r). ExpDate - 5Installation,alteraAon,or relocation
'+ ?no amps or less $50.00
Signature of Supr. Elec' _ 201 amps to 400 amps $75.00
401 amps to 600 amps $100.00 �..__
--�f r Over 600 amps to 1000 volts,
License No. Exp.Date�--__` see"b"above.
Phone No. __ � -
4d.Branch Circuits
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase of service or
Print Owner's Name __ feeder fee.
Address T Each branch circuit $5.00
b)The fee for branch circuits
City StateZip without purchase of
Phone No.__, service or feeder fee. +
First branch circuit $15 00 ?
The installation is being made on property I own which is not I Each additional branch clrculf $5 on
intended for sale,lease or rent. 4e.Miscellaneous
(Service or feeder not ircluded)
Owner's Signature Each pump or irrigation circle $40.00 -
Each sign or outline lighting $40.00
3. Plan Review section (if required): Signal circutt(s)or a limited energy-
panel,alteration or extension $40.00
�
Please check appropriate Item and enter fee in section 58. Minor Labels(10) $100.00
4 or more residential units in one structure 411.Each additional Inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection �- $35.00
Classified area or structure containing special occupancy Per hour V $55.00
as described in N.E.C.Chapter 5 In Plant $55.00
Submit 2 sets of plans with application where any of the above apply. 5. Fees:
Not required for temporary construction services. 5a.Enter total of above teen $
5„.Surcharge(.05 X total fees) $
NOTIS E Subtotal $ --
5o.Enter 2590 of line 5s for
PERMITS BECOME VOID IF WORK OR CONSTRUCTrON AUTHORIZED IS Plan Review It Mulred(Sec.3) $ ---
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF ICO DAYS AT ANY
TIME AFTER WORK IS COMMENCED. FjTrust Account x
Total balance Due
a
cwstsTi-cas err, Rev area
CITY CSF TIGARD
DEVELOPMENT SERVICES PLUMBING PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . . .. PLM96-0339
DATE TSSUED: 11/21/96
PARCEL: 15135DD-04400
'j I TE. 11-930 SW GREENBURG RL #200
SUBDIVISION. . . . : ZONING: C—P
BLOCK. . . . . . . . . . . LOT. . .. . . . . . . . . . . :
----------------------------------------------------------------------------------------------
CLASS OF WORK--,ALT GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. : 0
TYPE OF USE. . . . :COM WASHING MACH. . . . . . : Izi BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :S FLOOR DRAINS. . . . . . : 0 TRAPS. BASINS. . . . . . . :
,. . . . . . . . . . . : 0
STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : 0 CATCH SINS. . . . . . . : 0
LAUNDRY 'TRAYS. . . . . : to 9F PAIN DRAINS. . . . . : 0
SINKS. . . . . . . . . . : I URINALS. . . . . . . . . . . : Q1 GREASE TRAPS. . . . . . . . 0
LAVATORIES. . . . . : 1. OTHER FIXTURES. . . . - 0
TUB/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . 0
WATER CLOSETS. . : 0 WATER LINE (ft ) . . .
DISHWASHERS. . . . : 0 RAIN DRAIN (ft) . . .
Remarks : Tenant improvement -- Mike Stevenson
Owner: FEES --------------
MIKE STEVENSON type amount by date recpt
2825 DELLWOOD DR PRMT $ 25. 00 JSD 11/21/96 96-286827
5PCT $ 1. 25 JSD 11/21/96 96-286827
LAKE OSWEGO OR 970,ljtj
Phone #:
Contractor: ---------------------------------
MORANS PLUMBING
DONALD M MORAN
1.7577 S, RATTAN RD
OREGON CITY OR 97045
Phone #: $ 26. 25 TOTAL.
Reg #. . 1 007449 -------- REQUIRED INSPECTIONS
?his persit is issued subject to the regulations contained in the Rol.tqh—in Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other PLM/Un d e r f 3,o o r
applicable laws. All work will be done in accordance with Top—out Insp
approved plans. This pewit will eNpire if work is not started Final Inspection
within IN days of issuance, or if work is suspended for sore
than IN days.
Permittee Signat6re :
,s,Aed By .,
Call for inspection 639-41715
:ITY OF TIGARD Plumbing Application
Recd By �_� "�4I/v`
13125 SW HALL BLVD. Commercial a,id Residential Dale Recd
TIGARD, OR 97223 A
Date to P E. Jf
1503) 639-4171 Gate to DSTPermit is i ryi r' Sc1
Print or Type Related SWR# S-fe'?4- OG e
Incomplete or illegible applications will not be accepted Called__�_L I t -7L`�'�SY1,
—�^ Name of DevelopmentlProlect FIXTURES (Individual) QTY I PRICE AMT
JobSink
9.00
Address Street Address (�/7g.+s1 Stte. Lavatory 900
3 p s4U y �t(,j rub or Tub/Shower Comb'—_ 00
Bldg a City/State Zip Shower Only 900
Water Closet — 9,00
Namrei tDishwasher 900 I
Owner Mailing Address Suite Garbage Disposal 9 G0
j /✓4ttr��lX�i Washing Machine 9,00
City/State Zip Phone Floor Drain 2' 900
e4h t7s• 900
Name
4' 9.00
Occupant Mailing Address suite Water Healer 900
Laundry Room Tray 900
City/State Zip Phone Unnal 900
v~ Name/� / nlher Fixtures(Specify) J 900
1
y �) S 16t 4 900
Contractor Mailing Address-- - Suite 9.00
1] 1) S ff , ,�l' -- - -- 900
City/State Zip Phone 9.00
Al
Or on CCont.P_ ar Lic a Exp.Da ) — 9.00
Cons.
Attach Copy of do t_ ?-( 9.00
Current Plumbing Lic.0 Exp.Date Sewer-1st 100' 3000
Licensee _— Sewer-each additional 100' 25.00
COT eus m=ss Tax of Metro Ai Exp Date Water Service- 1st 100' 3000
Name —`— Water Service-each additional 200' - 25.00
Architect Storm&Rain Diain- 1st 100' � 30,00
or Mailing Address 3u,te Storm&Rain Drain-each additional 100'_ 25 00
Mobile Home Space 2500
F-nyin,fzer City/State Zip Phone Commercial Back Flow Prevention Device or Anti- �— 25.00 I
P0111,1tior.Device _JI
Describe work New O Addition O AlleratlorX Repair O Residential Backflow Prevention Device' 1500
to be done Residential O—Non-residential O Any Trap or Waste Not Connected to a Fixture 9 00
Additional description of work Catch Basin 900
Insp of Existing Plumbing 4000 1
pemhr
Existing use of '--_-- Specially Requested Inspections 4000
building or property
--- --- Rain Drain.single family3000 dwelling I 30 00
Proposed use of Grease Traps goo
Mudding or property_O k CC _ QUANTITY TOTAL
Are you trapping, moving or replacirg any fixtures) Yes❑ No❑ Isometric or riser diagram is rPouued a:uanrty Totals 9 —
(If yes see ba.k of form) "SUBTOTAL
I hereby acknowledge that I have read this application.that the information _
given,s rorrect,that I am the owner or authonzed agent of the owner,and S% SURCHARGE
that o!ans submitted are in compliance with Oregon State Laws. _
PLAN REVIEW 26%
Slgnat,%a Ow /Apent Data OF SUBTOTAL
//,'' Reawrea onry,f ri,rture Qty rotas 13>9
eG — TOTAL
Contact Person Name Phone _,__
� 'Minimum permit feu is 525-5'.S,surcharge.except Residential aacktlow
({3 7 Prevention Device,which is 515}5%surcharge
_ t idsts)iplmapp.doc 8/96
PLEASE COMPLETE AS APPROPRIATE TO PROJECT:
Fixtures to be capped, moved or replaced Qty
_Sink
I_Pwa',,ry
Tub or Tub/Shower Combination
Shower Only _
Water Closet
Dishwasher
Garbage Disposal
Washing Machine
Floor Drain _ 2"
3"
4"
Water Heater
Laundry Room Tray
Urinal
Other Fixtures (Specify)
COMMENTS REGARDING ABOVE:
It
CITY OF TIGARD MECHANICAL..
R lyT
l I
DEVELOPMENT SERVICES PERMIT #. . .. .P. . . . . : MEC96-02,91
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171
DATE ISSUED: 1, 1112196
PARCEL: IS13,5DD-04400
SITE ADDRF!F)S. 1. 1930 SW GREENBURG RP
SUBDIVISION. . . . : ZONING: C—P
BLOCK,. . . . . . . . . . . 1-11T. . . . . . . . . . . . . ..
CL-ASS OF WORK. . :ALT 1`71-00R FORN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :COM UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :B VENT�3 W/O APPI : I VENT SYSTEMS: 7
STORIE=S. . . . . . . . . 0 BOII-F.RS/COMPRESSORS HOODS. . . . . . . : 0
FUEL 0__ � HI-1. . . . : 0 DOMES. INCIN: 0
- /GAS/ 3---t5 HP. . . . : 0 COMMI— INCIN: 0
MAX INPUT: 0 BTU 15•-;;0 Hf'.'. . . . : 0 REPATR UNITS: 0
FIRE DAMPERS'% . 30--t 0 HK'. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . 510+ H!-:1. . . . - 0 CLO DRYERS— : 0
NO. OF AIR HANDL-ING UNITE) OTHER UNITS. : VA
FUPN ( J001-11 RT-0- 0 10000 cfm . 0 (7AS OUTLETS. : 0
FURN ) =100K BTU: 0 10000 rfm: 0
Remarks : Tenant impr,avpment
Owner: FEES
MIKE STEVENSON fypr- amm.tnt by date 1--ecpt
-'825 DELLWOOD DR PRMT $ 34. 00 R 11/12/96 96-286332
JPCt 'i $ 1. 70 P I I/ 121/96 '96-2186332
LAKE OSWEGO OR 970135
Phnne #.- 639-9835
Lurltt-af7trit-: ----------------------------------
COLUMBIA HEATING
PC) BOX 230397
TIGARD CIR 97281 ----------------------------------------
Phone #: 624-2704 $ 35. 70 TOTAL_
Req #. . : 76359
REQUIRED INSPECTIONS
This pertit is issued subject to the regulations contained in the Mpc-hanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other D� t Inspect ion
applicable laws. All Hark will be done in accordance with misc. Inspection
approved plans. This peroit will expire if work is not started Final Insr)er-ti.an
within 188 days of issuance, or if work is suspended for sore
Chan 180 days.
Permittee Sig to-we :
I d By
Call f(it- inspecticin 639-41 /5
Ptan Check 0
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P E.
(503) 639-4171, x304 nate tD F�� j
Print or Type Permit
Incomplete or illegible applications will not be accepted called
Name d 06"Op W.Up-1- Descnpow
,4 I, 0 Yi Table 1A Mechanical Code oTY PRICE MMT
Job Sh9111A0VOU (.,PkW- A) Permit Fee .0. .0- 10.00
Address ( Q
t3 Gryrsu i LP B) Supplemental Permit 3,00
719411P T41 7
wnw for n.ti a ousnaa� 1.) Furnace to 100.000 BTU 6.00
Owner h1 I<( > l Irl -tq t ind.ducts S vents
141111"Addr*U 2.) Furnace 100,000 BTU+ 7.50
Ick> QCL � /' ind.ducts&vents_
Cowsta. m I Pha» 3.) Floor Furnace 6.00
L' - ind.vent
Wrrr tar nw�r a i 4.) Suspenoed(heater,wag heater 6.00
or floor mounted heater
Occupant Mb"Adder" 5.) Vent nct vxL in
3.00
a001MCS pest 7
cM� apt Phone 6.) B der or cone,heat pump.ar a xw. 6.00 7
to 3 HP.absorp unit to 1 OOK BTU
N 7.) Boiler or comp,heat purnp,air cord. 11.00
C A a Pmll h 3-15 HP;absorp uN to 50oK BTU
contncw M"A*"= 6.) Baler or
� � / �> � .3 oil 4� cartehihp
,that P%e .airoomd. 15.00
,3.10 HP absorp unit.St mg BTU
Attach copy of C"Muft ?p PMne 9. Bader ar
Current Licenses 1 r �(! L� 7 ) comp.heat pump,air oond. 22 50
30-50 HP;absorp uni 1-1.75 rts1 BTU _
OrSOM Caret Cam Bora Litt Esp.owe 10.) Boiler or comp,heat
PinhP.air cord- 37.50
50 HP;absorp unit 1.75 and BTU
COT 8wrr s Tarr or aMto a E"L am 11.) Ar handling unit to� 4.50
10,000 CFM
Architect 12.) Ar handing unit 7.50
10.000 CTM+
or Mibp AMraft 13.) Non portable 4.50
evaporate cooler
Engineer C"St" no Phos. 14.) Vent fan coruuded 3.00
60
to a dud J(
Oesanbe Work New O Addition O Afde!ration O Repaw O 15.) Ver"etion system not 4.50
tr o be dons Residential O Non-residential O _ included in appliarwx permit
Amithonat Desuhpbon of won% 16.) Hood served by
mechanical exhaust 4.50
I ' 17) Domestic 7.50
E.zisbng use of 16.) Carmheroal or industrtal 30.00
txreidrg or property in irwator
19.) Cloches dryers,etc. 4.50
Pl000sed use of 20) Other units 450
budding or property '
Tfp(-of fact-od O natural gasp LPG O electric O 21) Gas pWq one to four outlets 2.00
aor
Fracknowledge that 1 have read this application,that the 22) More than 4-per outlet (each) .50
fcxrnabon reg^ n cned,thatIamthe,cwnerorauthomedagentof
l Yr_owner,that plans are#i a8ance with Oregon tate QTY.SUBTOTAL
laws
Sigrwture of Owne Agent Date - �--SUSTJTAL
i
l�' %Arr�6L Sti SURCHARGE �^
)'
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
TOTAL 3'
�doc 'Minimum permit fee is S25+5%surcharge
Rrav 7196