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15940 SW Greens Way
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line; 639-4171 MST
Date Requested L AM PM SUP
BLD
Location—__ Suite
MEC
Contact Person Ph �, `-f t , 6 cl&' �� PLM
Contractor _� — Ph - SWR _
BUILDING Tenant/Owner
��
_ 713 ELC _— —
Retaining Wall ELR --
Footing -- ..-- -
Foundation Access:
Ftg Drain FPS __
Crawl Drain Inspection iJotes: SIGN
Slab
Post& Beam — ---- --- -- --._— --._. SIT
Ext Sheath.'Shear _
Int Sheath/Shear l
Framing je!4 �ly<I le- mss' G49/s L✓/fr e-ce e .� 5 j _
Insulation
Drywall Nailing v /,u{� '0-- Ate it* �
—G�s s V �A,,-rA1-te10C
Firewall c
Fire SprinklerlAi f GN',0,4, !A kit itrt y i ��n,�` Gv�s a,o If
Fire Alarm T
Susp'd Ceiling � Gti'�1 �rL2syCd
Roof
Misc:
Final --
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab
Top Out _
Water Service —
Sanitary Sewer -- —
Rain Drains �-
Final ----• —__
PASS PAR' FAIL
MECHANICAL -�`—� -- ----- -
Post& Bearn -- —_
Rough In - `-- —
Smoke Dampers
MASS PART FII.
EL RIt;AL - — --
Service
Rough In - - -- -- --
UG/Slab —✓
Low Voltage
Fire Alarm
Final - --------. - _------•— _
PASS PARI FAIL_ — --
SITE
Backfill/Grading -- — —
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next Inspection. Pay at City Hell, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line f )Please call for reinspection RE: __ [ )Unable to Inspect-no access
ADA
Approach/Sidewalk
Other Date n —�Inspector f� J�l-� Ext
Final —""`—
PASS PART FAIL DO NOT REMOVE this inspection r•ecorer from the job site.
T�GARD Mt�HANICAI. PERMIT-
CITYO PERMIT#: MEC2001-00421
DEVELOPMENT SERVICES DATE ISSUED: 11127/01
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
PARCEL: 2S110DD-011 UO
SITE ADDRESS: 15940 SW GREENS WAY ZONING: R-12
SUBDIVISION: SUMMERFIEi_D LOT:U8`
E LOCK: 08" JURISDICTION:_TIG
---
FLOOR FURN: EVAP COOLERS:
CLASS OF WORK: OTR VENT FANS:
UNIT HEATERS: VENT SYSTEMS:
TYPE OF USE: SF VENTS W/O APPL:
OCCUPANCY GRP: R3 HOODS:
STORIES: BOILFRSICOMPR_ESSOSSO-_—_�S DOMES. INCIN:
0 - 3 HP:
FUEL TYPES 3 _ 15 HP: COMML. INCIN:
LPG BTU 15 - 30 HP: REPAIR UNITS:
MAX INPUT: 30 - 50 HP: WOODSTOVES:
FIRE DAMPERS?: 50 + HP: CLO DRYERS:
GAS PRESSURE: AIR HANDLING OTHER UNITS: 1
FURN < 100K BTU:
<- 10000 cfm: GAS OUTLETS:
FURN >=100K BTU: > 10000 cfm:
Remarks: Installation of gas fireplace insert end associated gas pipingFEES
—----
Own er_____— — Type gy date —r-Amount Receipt
ALVIRA 1. TROMP F�R�A TCT TCT R 11/27101 $72.50 2720010000
15940 SW GREENS WAY 5P( T CTR 11127101 $5.80 2720010000
TIGARD, OR 91214 -- -----
Total $78.30
-------------
Phone:503-620-8713
Contra__c—to r; ---------
LUDEMAN'S FIREPLACE + PATIO
12675 SW BLAVE-RD/`M RD REQUIRED INSPECTIONS
BEAVERTON, OR 97005-2129 Gas Line Insp -�
Mechanical Insp
Phone:646-6409 Final Inspection
Reg #:LIC 51469
will be done in accordance with approved
Sl ecialty Codes and all other app
permit is issued subject to the regulations contained in the Tigard Municipal Code, State of ded
re.
This pe licable laws. All work
w requires you to follow rules adopted in the Cregon
plans. This permit will expire if work is not starteLx�witlih� 180 days of issuance, or if work is suspen
for more than 180 days. AThose Iu)N Oregon
AR
Utility Notification Center. Those rules are SeseTulles or din Rect qupestionnsotofOUNC by calling-
9_52-001-0080- copies of the _
952-001-t'U80. You may
(r;n*j )AR-Q1 Rn > i permittee Signature:
Iss By:
Call (503)69-4175 by 7:00 P.M. for inspections needed the next slness day
Mechanical Permit Application MENNNIONMEN"
rd �..a����� /r ry Date received• ;�i'.,,/, F'ertnit no.:/'r,�,••�i ,-�../�
CA'.F�r of III 1L•�1 v C u Project/appl.no.: Expire date:
rY 8 At dress: 131%5 St'✓Hall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.:
Ci Ti and Pht.ne: (503) 61')-41'1 Case file no.: Payment type:
Fax: (503) 598-'960
c1 j Y Uh 7 1`J/11 Buildinrmit no.:
Land use aprroval: ' g
TIe0 Tenant impmvement
O Comercial/indust ❑Muiti•familyia, --&2 family dwelling or accessory m
New construction jf Addition/alteration/teplacement 0 Other:
�- �� Indicate equipment qu.ttttities in boxes below. Indicate the dollar
/ car: = -
/ Suite no.: value of all mechanical materials,equipment,labor,overhead,
Job address:
Bltig.no.: profit.Value$
Tax mapitax lot/accoun:no.: _
Subdivision: *See t,necklist for important application information and
glnck: ' junsdtction's fee schedule for residential permit tee.
0 rn
City/county: / r
ZIP: -
Description and location of work on premises: 12� Fee(e&)l Total
C i t- --
Descrpecu L~ fio L,/
Est.date of completion/ins
� Ra.ltd Res.Daly
Tenapt improvement or change of use' Air handling unit _— CFM
Is existing space heated or conditioned?U Yes U No Air con tuoning(Rite pan tequlr 1 is existing space insulated?U Yes U No teration o existing TIVT� system
I er/compressors
State boiler permit no.:
Business name; ,VeMA'�5 F,aPtAce 4Ajo PAT70 HP Tons BTU/11 _
Address: / (o Su t'U V Qrc�Q/rt -ua i smo a am uct arno e c etecwrs
eat Om file i an rf 1ol T1
City. r v
static: ZIP:9 _� �_=�__._ - 711
-
ir,sta rep ace urn urner_--
phone j3 � "� 31dyb E"tnatl• Including ductwork/vent liner U Yes U No
CCB no.: � ' - �oZ.. _ nate rep ac rn Deere te*.tcrs-suspen —
City/metrono.: wall,or floor mounted
0 l A tU ent ur apnp lance of er t > urnace
Name fplease pri:t): li L-u a r�erat
Abaarption units BTUM _
✓ Z_U ID JF M A f(--) C]iillers HP
Name: /t'l 4'e"
� C;cim res;ora HP
Addry s:{ -- �E roetwe taltaa un a ve®t on:
City:— state: ZIP: Appliance v ent
Fax: E-mail: eroxl east —
Phone: �iotT'�yp res. ttTTu eo ar�nat
hood fire su pression system — -- —
!
Ivaine: Exnaust ian with singie oust I nam 1128)
_ /t O/�t J --system,—
• aunt apart rom ealin or
Mailing address: ,%s r " } <<rl Fuelng P p ore(up to out els)
t
City: le"k state:c ! ZI a Ty�c: Lf'G ___t_ NCI Oil
Phone;,•" 1_ ' Fax: Email: vel i m eacTt n itiona over ou els
tGempp114(sc emaocrequi 1
Number of outlets
eros: �_ �1ber1Gia�P nonce or"equTpsi�t:
d ss: Dmotativefiteplace c�rt,
nsett--—typeO C
: —
state: ZIP: ---
_-----�-- -W— stov pe et stove
ton 1 Com' Email: er -
App atu2W t)y,,, ..+�+• Date: i trr: —
t` t d:• 4'Ltsc)t'�� - �N ., __
Perttit fee
e prin ... $ --
!!ainw+.!r�erl aedtt cam pkm CLU "fir WAM Notice This permit application Minimum fee................$Cl Viira tesCard' expires if n permit is not obtained Plait review(at — %) S
co-Ait card mmlw: within 180 days after it has been State surcharge(8%)....$ s1--
_ r ................. ...
r, .accepted as complete. TOTAL 6
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/a neroaW den r—I 971 name, cry o..
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