8665 SW GREENSWARD LANE OD
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8665 SW GREENSWA�V LANE
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CITY Q F TIGARD ME'[-,HAI,IICAL
DEVELOPMENT SERVICES PERMIT
13125 SW h,l/Blvd, Tigard,OR 97223(50'.1'639.4171 PERMIT #. . . . . . . : MLC98--0551
DATE ISSUED: t2/09/98
PARCEL: 26111PA-03101
SITE ADDRESS— : 08665 SW GREENSWARD LN
SUBDIVISION— . , GREENSWARD PARK ZONING: R-4. 5
BLOCK. , . . , . o . . .. : LOT. . . . . . . . . . . . . :007 JURISDICTION: TIG
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Ci—ASS OF WORK. . :AL'T FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY BRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . .. 0
FUEL TYPES-----_—___-- 0-3 HP. . . . : 0 DOMES. INCTN: 0
-BPS
3-15 HP. . . . - 0 rnmML. INCIN: 0
MAX INPU'l 0 BTU 15-30 HP. . . . : 0 RE;-'AIR UNITS: 0
FIRE DAMPERS?- . o 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 5514- HP. . . . 0 CLO DRYERS. . - 0
NO. OF UNITS-----__--- AIR HANDLING UNITS OTHER UNITS. : I
FURN ( 100K BTU: 0 10000 cfm: 0 BAS OUTLETS. .- I
FURN ) =100K BTU: 0 i 10000 cfm: 0
Remarks : listallation of gas fireplace insert.
Owner.: --- ---.-- FEES
MARCUS VANARCKEN & SANDRA VANARCKEN type amoi.int by date recpt
8665 SW GREENSWARD LN PRNT $ 25. 00 DLH 12/09/98 98-3114*L3
TIGARD OR 97224 5PCT $ 1. 25 DLH 12/09/98 98-3t1423
Phone #1 620-5077
Contra,:!tor:
JOHN 0 BRANCH FIREPLACES & MOR
JOHN OSCAR BRANCH
PO BOX 23698 11 26. 25 TOTAL
TIGARD OR 97281
Phone #: E20-0255
Reg #. . : 003958 ------- REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Bar, Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Final Inspection
approved plan,,. This permit will expire if work is not started
within 180 jays of issuance, or if worn is suspended for more
than IBP days. ATTENTION: Oregon le., requires you to follow rules
aloptrj by the Oregon Utility Notification "enter. Those rules are
set forth in OAR 952441-6110 through OAR 952-00I-0080. You say
Obtain copies of these rules or direct questions to OX by calling
(503)246-9187.
Issike By : Permittee Signati.tre:
.............................44•+++++++++++++.+++++++++++++++++•+++++++++++i++++++
Call 639-4175 by 7:00 p. m. for inspections needed the next blASiness day
..............................4-++-#.........................4.....................
CITY OF TIGARD Mechanical Permit Application Plan Checkif��__
PP Recd By .�
13125 SW HALL BLVD. Commercial and Residential Uate Recd 1v21. 9eF
TIGARD, OR 97223 Date to P E.
(503) 639-4171, x304 (� Date to DST_
Print or Type / Permit#//4�7 C 9g-D5�/
Incomplete or illegible applicatiors will not be accepted Called
Name of Development/Project Description — —�
Table 1A Mechanical Code _ _ City Price Am
Job street Address SuneM - A) Permit Fee 10.00
Address 1) Furnace to 100,000 BTU
includN ducts&vents 6.00
elope irylstate Zip 2) Furnace 100,000 BTU+ --
�_--- — fit r 1"Ic
+ ` n including ducts&vents — 7.50
Name(or name ofbusiness) (I.l 1�.(7 r C ' 3) Floor Furnace
Owner NkO, fi�., "d _ t.8, VC'--41 ,, _including vent _6.00
Mailing Address 4) Suspended heater,wall heater
or floor mounted heatr _ _— 600
5) Vent not included in appliance permit
CRY/slate Zip Phone 300
7 2,2- -7 CHECK ALL *Boiler Heat Air
_- Name(or name of business) THAI APPLY: o. Pump Cond Qty Price Amt
_ Comp_
__ 6)<3HP;absorb unit to
Occupant s�,i,npAddress v 100K BTU _
_soo
7)3-15 HP,absorb unit W
Cnylstate Zlp Phone 100k to 500k BTU _ 11.00
8) 1� 30 HP;absorb
-- - unit.5-1 mil BTU 15.00 _
Contractor Name 930-50 HP;absorb
unit 1-1.75__ mil BTU __ 22 50
Prior to permit M ling Address _ 10)>50HP,absorb unit
issuance,a copy IC 13�t �3��� >1,75 mil BTU _ 37.50
of all licenses CRy/Stale Zip Phone 1111)Air handling unit to 10,000 CFM
are required 4 1, . ,�i �a1 AE L 6/-o Y4.50
expired in COT Oregon Const Cunt.Board Lic N Exp Date 12.)Air handling unit 10,000 CFM+
_ database _ ?1) �L{ t1-cj
,— _ 7.50
Architect Name 13)Non-portable evaporate cooler
_ 4.50
or Mailing Address 14)Vent fan conn,?rted to a single duct
3.00_ _
15)Ventilation system not included in
Engineer CnyrState ziu Phone appliance permit 4.50
16)Hood served by mechanical exhaust
Describe work to be done: - -- -- —_—_ 450
17)Domestic incinerators
New 6 Repair O Replace with like kind Yes O No O _ 7
Residential IQ Commercial O 18)Commercial or industrial type incinerator
30.00
Additional information or description of Work: 19)Repair units
1A.S1191"4;w^j AF /GliPF_1�lAt�� 20)Wood stove 450
450
21)Clothes dryer,etc.
4.50
Type of fuel oil O natural gas.V LPG O electric O 1 22)Other units
__ ___ 4.50
1 hereby acknowledge that I have read this app�`cation /hat the information 23)Gas piping one to four outlets
given is correct,that I am the owner or authorized agent of 2.00
the owner,that plans submitted are in compliance with Oregon State laws 24)More than 4-per outlet(eachl
50
5lgnat of owneHA ent Date
Minimum Pertrit Fee$25.00 _ SUBTOTAL aha
-
C,
� /C✓� __-_
_ v 5%SURCHARGE / e�
,antact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
Re ufred for ALL commerclal permits onl
TOTAL
'State Contractor Boiler Certification required
-Residential A/C requires site plan showing placement of unit
1"echperm doc rev 0//20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hoar Inspection Line: 639-4175 Business Line: 639-4171 MST _-- -- --
,�- � "`1'2&� BUP
-_1!���-Date Requested /o� 4/,a--
_AM_ PM _/ BLD -- ---
Location__ c��1�� nJ Suite EC —
Cc,ntact Person / Ph C> `" �� PLM
Contractor _ _ Ph _ SWR -
BUILDING Tenant/Owner ELC _
Retaininq Wall ELR
Foundation
Footirg -- -_-__----
Access: '
C' FPS
Fig Drain
r
Crawl Drain Inspection Notes: SGN
Slab
Post& Beam --�---- __.- __--- SIT _ - ---
Ext SheaT/Shear
Int Sheath/Shear - -------- -
F rami ig - --_
Insulation --
Diywall Nailing
Firewall T
Fire Sprinkler
Fire Alarm
C-usp'd Ceiling
Roof - ---- ------__ ---�.-- -
Misr
Final -_ ------- ----
PASS PART FAIL ---- --- ----_---- ---------------_._.----_.-_
PLUMBING
Post& Seam - - -- ---- ------------- -----
Under Slab
op Out
Water Service
Sanitary Sewer - -.____�.----------- _
Rain Drains
Final - - --- - --
P ^ FAIL
MECHANICA 11 LD
n
F'os eam� -
Rough In
Gas Line -- - ----
Smoke Dampers
PART FAIL.
EL _ RILAI
Service _
Rough In -
UG/Slab
Low Voltage _ —�---
Fire Alarm
Final --___ - ---- -- --
PASS PART FAIL
SITE
Backfill/Grading -- - - - - --- __-.
Sanityry Sewer
Storm Drain ( ]Reinspection fee of$_ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE:-_ - T _ ( ) Unable to inspect-no access
ADA
Approach/Sidewalk , 1 \
Other _ Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.