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CITY OF TIGARD BUILDING INSPECTION DIVISIONMST 2-3
24-Hour Inspection Line. 639-4175 Business Line: 639-41)'1 �
g p BLIP
Date Requested U �O AM PM
Z _r , -�-- - BLD _
J� ��1 ,(Qf Suite
PAEC
Location
Contact Person `-'�� `yn �y,.c.C.+E�Q•1,�Qy1, Ph 52 Cf - 5 2- �'�J PLM
Contractor _ Ph SWR _
BUILDING —^1 Tenant/Owner 1.���uE�ct E LC _
Retaining Wall _ ELR
Footing Access
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes. SGN n _
Slab
_- .. SIT
Post&Beam - —
Ext Sheath/Shear
Int Sheath/Shear
Framing ;LIS
Insulation ____.__ �� l�r c c ����� �•
Drywall Nailing
Firewall —--- '--�---
�Fire Sprinkler
Fire Alarm
Susp'd Ceiling _ Y —
Roof — '-
Misc:
Final
PASS PART FAIL_
PLUMBING
Post& Beam --
Under Slab
Top Out --
Water Se!vice
Sanitary Sewer
Rain Drains
Final --
PA -f'ART`' QIL
lA►hF1@iett "
Post S Beam -
Rough In
Gas Line
JSq1gk&Dampers f
A S PART FAIL
ELECTRICAL
Service _
Rough In
UG/Slab
Low Voltage
Fire A'iirm
Final
PASS PART FAIL I _
SITE
Eackfill/Grading — ------._
Sonitary Sewer
Storm Drain ( 1 Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 FV11 Hall Blvd
Catcl,Basin
Fire Sopply Line ( I Please call;t r rear spection RF: _ ( ]Unable to inspect-no access
ADA
Approach/Sidewalk Q
Other Date 8 '�8 ��/ Inspector. , _ Ext
Final
PASS PART FAIL_ 00 NOT REMOVE this inspection record from the job site.
CITY �F T I VAR D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2004-00045
1'-12.5 SW Hall Blvd„ Tigard, OR 97223 (503) 60-417'1 DATE ISSUED: 2/4/04
PARCEL: 1 S 133DA-02600
SITE ^.nnPF,S- 12855 SW GLACIER LILY CIR
SUBDIVISION: AMART SUMMERLAKE ZONING: R-7
BLOCK: LOT: 048 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEi SS:
STORIES: _BOILERS/COMPRESSORS HOOL S.
—':U-EL TYPES _ 0 3 HP: DOMES. INCI V:
LPG i� — 3 15 HP: COMML INCIN:
MAX INPU BTU 15 - 30 HP: REPAIR UNIT is
FIRE DAMPERS?: 30 - 50 HP.
WOODSTOVE",:
GAS PRESSURE: 50 + HP: DRYERS:
FURN < 100K BTU: 1 AIR HANDLINGOTHER UNITS:
_ UNITS CL.O DRYER
FURN >=100K BTU: <- 10000 cfm
> GAS OUTLETS:
10000 cfm:
Remarks, Pcnwme and install gas fumak
Owner: -. - -- — _ FEES
WILKERSON, KENNETH J/URSULA E Description Date Amount
12855 SW GLACIER LILLY CIRCLE — –
TIGARD, OR 97223 IMEC'H) Permit Fee 2/4/04 $72.50
"rAX I R"S.,tate 2/4/04 $5.80
Phone: _ Total $78.30
Contractor:
A-TEMP HEATING& COOLING
16000 SE EVELYN S-F
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 503-650-9602 Heating Unt Insp
Final Inspection
Reg LIC 71878
This permit is issued subject to the regulations contained in the Tig,-,-d Municipal Code, State of Ore.
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 requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. Yor; may obtain copies of these rules or direct questions to OUNC by calling
(503)246-66W"
Issued By: !�{ ' <<'�-' 'f 1 � Permittee Sionaril,-e: h ('
Call (503) 639-4175 by 7:00 P.M. for inspections nPoded the next business day
M
ra>_�i�exrr��r�a►
SFR-02-2004 10:5' A iEh1P LIE�JIHG 5035572990 P.02i02
Mcchanieal Per11nit .� > lea tion Received, Mechanical
—' UaIdU : -1-()� �l- Permit NoZ.." . : %LYJrJ
Planning Approval umlding
city of Tigard � ha��,t� Perm+l Nom_._ .
`� V Plan Rcviow 01W1 lIS SW Halt Blvd. /�CV`� �_v Uat✓1)Y: • Permit No.: _..._._
Tigard,Oregon 97223 �� incl Itevicw land Use
Phone: 503-639.4171 rax: 503 598-19A� I)ale/1ly: Cur,No.: _
Inlemtel; www.ci Ugard.or.us U c� "' Contact tuns: See Page 2 for
l E,"' Nan+c/Nctlu+d. Su +lemenlallnforrnalion.
24•hou[InspecUnuRcciocst: S 3)-�1�17Cr5,F,( —
oAN o� 1, 1�',I-A,4
twIf)IN ,D _ __ —.
'I yP .0 %, RK. ,_�. — _ COMMERCIAL FEtE_*S�Ct1EDUI.E-USE CIiEC_KLIST.
New construction Demolition Meehauical permit fees'are balled on the total value or the%mrk
� perforowd. Indicate the value(rounded to the nearest dollar)of all
Addition/alterIi i± lacement` Other: mechanical malerials,equipment,labor,overhead and prorit,
"
'CAT GO .0 TRUCTION %,a111a1 S-� See Page 2 for Fee Schedule
I &2-Family dwelling _Cummercial/Industrial RESIDENTIAL E IAPMENT/5 STEMS 6E•SC1 t1LF+
Acce.sso Buildin multi—Tamil pearl llont Fee to. TCuI
Master Builder El Other; ue 1 n coolitt —�
14.00
.JOB�, E INFORMATION and 1. ATION 'urns add-on air conditionin " 14.00
W G as heat dump — 14.00
Job site address:
_Duct work
Suite#: 1310!0A it. I I dronic hot water s stem 14.00 _
Project Name: -�-'� — Residential boiler
Cross street/Directions to job silt' for radialoi2r llydronic system).....
1 .00
Drill healers(fuel,not electric)
in wall in-duct sus nded etc. 14.00
Fluelvenl Our atlyurabove 10.00
Rc air units 12.15
Subdivision: _ l.ul>!1: Other Fad A Ilences
Tax map/parcel #: Water healer 10.00
DFUCRIPTION OF NVORK 10.00
00
.L -- Flue vent wsler heater/ as Grc lace) 10.
— Lo li liter ate_ _ 10.00
Wood/Pcllel slovc 10.00
Wood r act c If dinaerf 10.00
Chimney/Ilncr/1lue/vent 10.00 _
Other. 10.00
OPCRTV OWNER TENAN En onnlantal Eahauat dr Vcntllatlo
Name: I � trS _ _ Range hoodlother kitchen equipment 10.00
Address: Z k) a C,if—V� p4,I . ' Cloth es dryer exhaust _ 10.00
Clt /Stale/ZI �- a Cl- .. .1..Ls: 3 Single duct exhaust
1 homle Fax: (bathrooms,toilet compartments,
CONTACT'PERSON
ulllit rooms) __ 5.80
APPLI NT �-- Allidcrawl s>acc fans, !+x.00
Nam10-00
— _Fuel PI In -
Address; q -city/state/zip:t��_ Q ,1 _ '•ts •4g- r°r tirar/ tl•OO each addltlonal
Fumaee,etc. _ •a
Phone. ^b 'max_-ap � Gas heat Pump
E-mail: \ Walllsus ended/unit heater
�•RACI•oR _ Water heater — •°
-='-- Fire lace •�
Business Nam — ••
Ran c °•
r �
Address: I I BDQ
Cil /State/ZI Cloillae ctr cr tum 1 •:_
h
O
Pter: �=—
hone: C_ Total:
Cllr ' �-��
CCB Lic• _ —.— .—. _ Mechenteal Permit Fees•
Authorize >♦ �� Z(� t Lf -__ _ Subtotal: s `
1 Minimum Pcnnit Fee$72.50 S _
I'Inn Rcview Fee 25y.of Permit f ce S
Stale_Surchar c 8°�.of ermit Fee S
(Please pint:+ante) TOTAL PERMIT FEE S
Ilallon ea fres Ir a rr mlt it n+l ablalncel rillhln •Fir nicihodoineY ret by Trt•Counly Ralldinly Industry Se Ile Beard.
Nonce: This permll app P F *site pirn requlrrrl for exterior A/C un4s.
I80 days aver it has been aeeepteA as complete.
i;\Nts\Permil Fotnu\MecPcrmitApp doc 01103
TOTAL_ P.0,-
CITY OF* .BARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION; DIVISION Business Line: (503)639-4171
BUP
Received Date Reques ed AM PM PM BUP
Location Z ✓C s 'Suite_ ME
Contact Person 6�Qtite ,yt_ 1� L J� 5 -- Z(�S PLM .
Contractor •WC Ph(---- ) SWR
BUILDING Tenant/Owner ELC
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 0Yy� . J�j SIT
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear s,. �� �rn.4G lw�L div e/y f 'L.. Y'J j/4 /j,�,�S�4i�f -
Framing
Insulation
Drywall Nailing --
Firewall
Fire Sprinkler -- -
Fiie Alarm -
Susp'd Ceiling
Roof
Other:___ —__-
Final
PASS PART FAIL
PLUMBING -_^— -_- -
Post&Beam
Under Stab - --- ----- -
Rough-In
Water Service -- -- - -'
Sanitary Sewer
Rain Drains -- ----
Catch Basin/Manhole
Storm n rain --- ------—
Shower Pan
Other: - -
Final
PASS PART FAIL
_MECHANICAL
Post& Beam
Rough-In -----
Gas Line
Smoke Dampersr-70 - -
F a
S PART FAIL -
ELECTRICAL
Service
Rough-In _ -
UG/Slab
Low Voltage -
Fire Alarm
Final Reinspection fee of$_ requ'red before next inspection. Pay at City Heil, 13125 SW Hell Blvd.
PASS PAPT FAIL
SITE Please call for reinspection RE: Unable to Inspect-no access
Fire Supply Line
ADAExt
Approach/Sidewalk, Date -�� _ Inapeotor ---
Other: ,- _
Final DO NOT REMOVE thle inspection record from the job site.
PASS PART FAIT.