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11080 SW king Richard Dr
CI YY OF T I GA R® _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMITM MEC2003-00010
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 1/14/03
SITE ADDP,=CS: 12080 SW KING RICHARD DIS PARCEL: 2S115BC-12300
SUBDIVISION: ZONING:
BLOCK: LO F: JURISDICTION: KIN
CLASS OF WORK: OTE' FLOOR FURN: v EVAP COOL-ERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS HOOL`S:
_
FUEL TYPES _ 0 - 3 HP: 1 DOMES iNL;IN:
- 15 HP: COMML. INCIN:
MAX INPUT BTU 15 -30 NP:
FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVE-.
FURN < 100K BTU: _ AIR HANDLING UNITS CLO DRYERS:
FURN >=100K BTU: <= 10000 cfm: OTHER UNITS:
10000 cfm: GAS OUTLETS:
Remarks: Install new Al,. Cannot be placed in required setbacks.
Owner: _ FEES
WILLIAM SINAY Description Date Amount
12080 SW KING RICHARD DR — - -- —
K11"(3 CITY, OR 97223 [MECII] 1'einut I cc 1/14/03 $72.50
["I AX) 8%:;1ate l ax 1/14,"v3 $5 80
phone: 0-1-639-1117 _ Total $78.30
Contractor:
GL HEINTZ HEATING& COOLING, INC
20871 SW 216TH PL
SHERWOOD, OR 97140 REQUIRED INSPECTIONS
Phone: %3-G25-6798 Cooling Unt Insp
Final Inspection
Reg #: I IC 102831
This permit i;; issued subject to the regulations contained in the Figard Muni ;ipal Code, State of ')re.
Specialty Codes and all other applicable laves All work will be done in accordance with approved
plans. This permit will expire if work is riot started within 180 days of issuance, or if work is suspencied
for more than 180 days ATTEN TION: Oregon law requires you to fQII0W rules adrpted in the Oregon
Utility Notification Center, i hose rules are set f(.;st" in OAR 952-001-0010 through -)AR
952-001-0100. You may obtain copies of these rules or direct questions to 01 i y calling
(503)246-6699. ,
Issued 9y: Permittee Signature: , 1�(
Call (5u3) 639-4175 by 7:00 P M. for inspections needed the next 'ausine,s`day
P,1/09/2003 14:34 5036393771 CITY OF KING CI F'AGE 0:/02
A-Am VA
hlecli >uical Permit tion7D&" 701
' Mechanical
Permit No.: ) -U /n
Lit U1F Tigard 13uiiding
yg _ Permit No.:
13125 SW Hall Blvd, JAN 0 9 2003 Other
Tigord,Oregon 97223 Date/By Permit No.:
Phone: 503-639.4171 Faxi;,13 4W-10AA K Post-Review rand Use
Date/By: Case No
Internet: www,ci.tigard.or-RA)ILDING I MSV Contact luris.: ® See Page 2 for
24-hour Inspection.Request: 503-639-41 5 Namat Method:_ Su ►omental Information.
(' 41 ' I ,! ,pR .!i:, '�. 1�,4 �� {�',']t :ir, i..;::M I '1�aF.[7eLIDCr
New construction Dernr .ition Mechanical permit fees*are bared on Ilie total value of the work
Additioti/alteratio /re lacemertt Clther perfornted. Indicate the vaIua(rounded to the nearest doll at)of ail
( CTn ! 1 --, - , , ,,,,;•, mechat ical materials,equipmtrit,labor,overhead and profit,
EE
2 Family dwelling Co i lnercial/Industrial value: S See Page 2 for Fee Schedule
Accesso Buildin Multi-Family 2Z"
Descri tionty Fet(eaj Total
Master Builder Other: tin ,C6,Il '
u ,' •i �C3j . :''''�'' °'•
Furnace•add-on a!r condition in ** 1 1 14.00
Job site address: �. Cas heat u 14.00
Suite#: elm/Apt#_ Duct work _ 14.00
Project Name: H ronie hot water system i_ 14,00
Residential boiler
Cto'r stieet/Di.rections to job site. _ for radiator or hydronic rati m 14.00
I Unit heaters(fuel,not electritj
in wall,in-duct,suspended,.Jrtc. 14,00
Flue/vent for an of above 10.00
Subdivision: Lot W Repair itnits ,: is
Oth��i„ueh sea.
Tax mliI nrcel#: _ Water heater _ CO
paa fireplace 10.00
O h_ Flue vent water heater/ s fire ilacc 10,00
I Lo lighter as �{ 10.00
_111.1nod/Pellet stove I 10.00
Wood f:re lace/insert I 10,00
_ Chimne /linsr/flue/vent-1 10.00
other. 10,00 —:c-
Nalne: �nvlrlt00hl�ix rl rlti .. __
�^ - Range hood/other kitchen eqLlipment 10.00
Address: ( Clothes dryer exhaust 10,00 _
City/State/ i - --- — -
��--- Single duct exhaust ��
I'hone: x: (bathrooms,toilet compartminits,
utility rooms _ 6,80
Name: y� Attic/crawl space fans 10.00
Other; r 10.00
Address: --�- 1 --
city/state/Zip; '•S;i.40 for It,ru 451.0 each additions
Phone: _ Fax: _ T Furnace etc. ••
Cas heat pump — **
E-mail: Wall/suspended,,nit heater •*
;;1 E U i i j :" :I :.r Water heater _
Business Name: Fire lice _ **
Address: Ran
__ B11 •«
City/State/Zi Lo _�� _ l 0 Clothes dr erspas i **
Phone t6 Fax: other; _ ••
C(13 LIC. #: —- Total`
Authorized - - Nlk nl' ,P, ' It ote
Subtotal:
Signature: -..-_ t)ate:l'�q-b
i Minimum 114,,rmit Fee$72.50
Plan Review Fee(251/9 of Permit Few W
(Please print name State Surcha eg 8%a of Permit Fee) $
_TOT►L PF;RMIT FEE 4n I
Notice: This permit application explree f a pot mit I%not obi aIned aithln "Pet mrthndnin,+,y tet by Tri-ounfy Building indurtry Srrvlce Boar
180 days after if hot been accepted as complete. '"Site plan required for extM fur A/C units.
:;\Dsts\Permit Fortns\MecPerrnitApp.doc 01/0! ;
01/09/2003 14: 34 5036393771 CITY OF KING CITY PAGE 01/02
KING CI'T'Y"
mvw� 13100 SW, 116th Avenue. King City,Orepn 97224 Nomr 1-39.4082
IF Ark'%e (Z)1-7=1q,' S 14 H: J—r-'rV
DATE
TO
ATTN
FROM : 14
MESSAGE : —
This transmittal contains pages , incl-id I ing this cover
Sheet . If you experience any problems , please contact :
City of King City ( 503 ) 639-4082
Fay. Number ( 503 ) 639-3771
CITY OF TIGARD 24-Flour
t3UILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Busim s Line: (503) 639-4171 MST
BUP
Receivad _- - -____Date Requested_ AM-_ PM.— ___ BUP
Locatior � ADC7 U
Suite�`?`�� _ MEC -�
Contact Person _-.. Ph(_ ) -, -5_1a-3 PLM _
Contractor ( _) — _
Ph SWR
BUILDING Tenant/ si9_1`—_ _ _ __ ELC
----------- -
Footing - �' — //
Foundation Access: ELC _--
Ftg Drain ELR
Crawl Drain -------_--- -___—
Slab Inspection Notes: SIT
Post&Beam --
Shear Anchors --- -- -- --
Ext Sheath/St'Adr
Int Sheath/Shear
Framing -- - - -_
----------------------- -
Insulation
Drywall Nailing —
Firewall
Fire Sprinkler - -
Fire Alarm
5usp'd Coiling — -- - - --
— --
Root G
Other --- -
Fi,ial
PASS _PARTFAIL_ — —�
PLUM_BINGS__
Post A Beam
Under Slab --- - -- .
Rough-In
Water Service - -
Sanitary Sewer
Rain Drains
Catch Basin/Manhole
Storm Drain - - -_ - -----
Shower Pan
Other
Final
ASS PART FAIL --
CHAN16__L,
Post&Beam
Rough-In ----- --
Gas Line
Smo a Damper., -
P PARI FAIL -
ELECTRICAL -__.___
Service — --- - -------- ------------ ---- — --
UG/Slab
Low Voltage
-- -----------------------------------
Fire Alarm
Final Reinspection fee of$ required before next Inspection. Pay at City Hall 13125 SW Hall Blvd.
PASS PART FAIL
Please call for reinspection HF —_ Unahle to inspect-no access
Fire Supply Line
ADA
APP roachiSidewalk Date �� Inspector A Ext
Other:
sinal — DO NOT REMOVE this Inspection record from the Job site.
1`ASS PART FAIL
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Lane: 639-4171
BUP _
Gate Requested AM __PM BLD _
Location l��D�y >^ ��t l��:f�� Suite __ MEC
Contact Person _�; Gt ���y,�c. I r� 5�e44 Ph GP�`�-kS3s PLM
Contractor Ph SWR _
BUILDING e Tenant/Owner ELC
Retaining Will i ELR
Footing Access:
Foundation FPS _
Ftg Drain SGN T
Crawl Drain Inspection ,?es: / ----
S'ab (( SIT
Post& Beam41
Ext Sheath/Shear
Int Sheath/Shear w
Framing
Insulation -�
Drywall Nailing
Firewall - -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling _
Roof
N isc:
Final
PASS PART FAIL _- -. -_--
PLUMBING
Post& Bearn — ------ ------- --- --- ----- - ---
Under Slab
Top Out
Water Service
Sanitary Sewer /
Rain Drains
Final
PASS PART FAIL
. -
Post& Deam
Rough In
Gas Line -- -------- -- -..----- - -
S oke Dampers
P $-, PART FAIL
E ECTRICAL ----------- - ------- ----- ---
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL__
SITE
Backfill/Grading ---- ' -�- '--- --
Sanitary Sewer
Storm Drain I J Reinspection fee of$ ,required before nex'inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ , f-lease rail for reinspection RE �_- [ ]Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Inspector Ext
Date 1 I �L
Other _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
/^ CITY OF T I G A R D MECHANICAL PERMIT
DEVELOPMENT SERVICES ` PERMIT#: MEC1999-00535
\ DATE ISSUED: 12/6/99
13125 SW Hall Blvd., Tigard. OR 97223 (50V17 PARCEL: 2S115BC-12300
SITE ADDRESS: 12080 SW KING RICHARD DR
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERSICOMPRESSORS _ HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
-- OTHER UNITS: 1
FURN >=100K BTU. <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas stove and associated gas piping.
Owner: _— _ -- — FEES
gWINT, HELr_-N H AND Type By Date Amount Receipt
S dIIT. jF-AN E PRMT LEB 12/6199 $50.U0 KING CITY
1206.0NCITT SY, OR 97223 KING RICHARD 5PC"I DEB 12/6/99 $4.00 KING CITY
KING
Phone: Total $54.00_ `
Contractor:
FIRESIDE DISTRIBTRS OF ORE INC
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Gas Line Insp
Phone:503-684-8535 Mechanical Insp
Reg #:LIC 00040979 Final Inspection
This permit is issued subject to the regulations contained in the Tigard 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 952-001-0080.
Yomay obtain cppies of ttrse rules or direct questions to OUNC, by calling (503)2.46-9189
Issu .)By: i` Permittee Signature:
Gall (503) 639-4175 by 7:00 P.M. for inspections needed the nexfbusiness day
-99 MON 09;06 AM City of King City rr"AX.503 639 3771 PA(:-
RE( IVED Plan C ea�sl=
CITY OF TIGARD Mechanical Permit Application Read , Y.
13125 SW HALL BLVD. NMI 2 9, 1NOommercial and Residential Uate Rec'd.i�
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, x304 Date to DST
Print Or Type Permit d
Incomplote or illegible applications will not be accepted Called _
I Name ar DevllopmcnVPmied Description -
Table 1A Mechanical Code Qty Price Amt
Job Sinai Address _ – SuMea A) Permit Fee —
_ _ -- ° 16.00
a
Address 1p�(� 5'.,14n Qac�� 1) Furnacoto 100,000 67u— -
ii.Audi ducts&vents seg footnote 1,T 9,65 idgu cetera zip 2) Furnace 100,000 BTU♦ -
�(Z 9-1 Z Including We 8 vents see footnote 1,2 12.00
Name(or memo-,of husin"Ss) 3) Floor Furnace _
Ownerincluding vent see footnote 1,2 9.86
4) Suspended heater,wall heater
Mailing Address _
p or floor mounted heater see footnote 1,2 9.85
aobO_ &_J c 5)_Vent not included in appliance permit 4, 5
ChylStare imp Phone Chei*all that apply' "Boller Heat Air
For Items 6.10,sea or
_ � '}•� M �y� iG� Pump Cond Qty Price nmt
- Name( nar,e usintSS) foelnotes 1,2 Comp^ "'
6)c3HP;absorh unit to
Mailing Address ___ ___ 100K BTU _ _ 9.65
Occupant 7)3`15 HP;abrofb unit
1 OqJ to 500k BTU 17.65
Cxyrstate 7Ip Ph„ 8)15.30 HP;absorb
unit 5-1 mil BTU 74.15
—– 9)�aAO HP;absorb
zonaCtor N°R1° unH 1.1.75 mil BTU 3f.00
:1 r QST 1.,1�$ t0)?54HP;absorb unit
permit ►� Illnq Aedrese � a1.75 r.i'BTU ) __ 15
tsuance,a copy (W j � � - �j �f 11 Air ndling unit to 10,000 CFM
of all licensesny/Slate tip Phone 400
are required ff Mpr I.� L ( - 12)Alr handling unR 10,000 CFM ;
expired in COT Oregon const.cant.Beare L c;rr Axp new a 11.85 .
databaseZ'�
� I( `CO 13)Non-portable et,sporste cooler
-Architect N3Te 7.00
14)Vent fan connected to a single duct
or MauTnAAdmes� 4,75 --_-
15)Ventilation system not included in
appliance permit 7.00
Engineer CMyI rare Zip Phone 16)Hood served by mechanical exhaust
_ 7.0_0_
Dr�scnbe work to be dune: 0 17)Domestic Incinerators
12.00
New 0 Repair 0 Replace with like kind: Yes O No 0 16)Commercial or Industrial type Inelnersior
Residential _-& Commercial 0 48.25
_ 19)Repalr units
Additional information or description of work;'v�,d� ,t _ ___ Bao
t, � � �"d' 20)Wood stoves%qas FP/other unitslelothe dryerlelc
d 7 no
NOTE: For Commercial prolecti only;Units over 400 tbs,require 21)Gas piping one to four outlets
structural gas calcs. see footnote 1 3,75 �S
Type offuel: oil O natural gas* LPG O el-.ctricO 22)More than 4-per outlet(each .75
Minimum Permit Fee$S0.00 SUBTOTAL 5D
I hereby acknowledge that I have read this application,thvt the information SURCHARGE MAW 4.
given is carred,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAI_
the owner,that plans submitted are in cumpliance with Oregon State laws; Retired for ALL commercla!permits only _
TOTAL ld
g
V. 1..
f lure M Ownerr 9h � Date
Other Inspections and Fees:
I- I Z--.. 1. Inspections outsldo of normal busines,hours(mininurn charge-two
~ I- -1 —
nn ct Person a e Phone hours) S50.ou per hour
r _ 2. Inspections for which no fee Is specifically indica'ed (minimum
35 charge-half hour) $50.00 per hour
Foointes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to
1 Provide rill srhematic of existing and proposed pas line and pressure. plans(minimum charg(,-one-half hour)$50.00 per htwr
2 Provide drawings to scale showing existing and proposed mechanical
i units "Slate ContrRctor Boiler Crrtifira+,fun rFquucd
-_ . __ _ —_ -Residential A/C.requirns site p'in showing planvmeint o'unit
1.vrerhperm doc iev 7/Ig199
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KING'CIT E- STRUCTURAL CHANGE REQUEST
Member Date
42
Address � ��� �1� Phone
TYPE OF CHANGE
(Patio Cover, Room, Fence, etc.)
PLAN:3114ENS.I.ONAL JWD MATERIAL DETAILS
Nnte :
1) Adjacent property owners will be informed of the requested change.
2) If there is an objer.tion, the objection, but not the name of the objector, will
be given to the member asking for the change.
3) The Board of Directors of the Civic Association will review the Mans and property
for approval or disarproval and compliance with the stated restrict:-ons.
Q A building permit must be obtained from the city for all improvements costing over
v 500.00
a
I
Date Notified 71/ / �� KCCA Board of Directors
-----" _� "resident
Date to be Completed ( � Arrroved icV" a President
Final InspectionDisallowed (Reasons)