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12364 SW KING GEORGE DRIVE N W A N Z m Q G7 rn v l t • RGE DR. 1�3bq SW KING GEO CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Lit1e: 639-4175 Business Line: 6394171 MST — BUP _Date Requested` ,,21-) g�� AM PM _ BLD Locatiol�� ( �' �t�� U e�Y� Suite MEC Contact Pr--on Ph PLM Contractor �a' Ph �' :�25�.LL�` — SWR _ I JUILDING 1'en,,nt/Owner ELC _ Retaining Wall Fooling Azcess: ELR ^--._—�-- — Foundation FPS Fig Drain — ---- Craw` Drain Inspection Notes: SGN Slab ------ Post&Beam _---- --- -- ---- -- -- SIT Ext ---- — --- Ext Sheath/Shear Int Sheath/Shear Framing -Insulation - Drywall Nailing Firewall Fire Sprinkler Fire Alarm --- - - -- Susp'd Ceiling _-- Roof —�—- riFnal isc: - -------- --- --- - PASS PART FAIL -- ---- __. PLU119BING Post&Beam Under Slab Top Out Water Service Sanitary Sewer - _---_ Rain Drains Final --------- - P PART FAIL _ -C ANIC I U h ,Imo e Dampers rna i ___ _— - -- -- -- --- —— ---------- A PART FAIL RICAL -- ---- ---- — _ --- --- ervic;e Rough In — ---------- —_ UG/Slab Low Voltage ___--- Fire Alarm Final PASS PART FAIL SITE Backfill/Grading Sarr!ary Sewer Storm Drain [ J Peinsperiion fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire SLrnn!y Line [ ]Please call for reinsNertion RE' )Unable to inspect no access ADA Approach/Sidewalk Other Date `2. Inspector � /�►"^� Ext Final PASS— PART FAIL 00 NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING ini PECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- _ BLIP Date Requested 5,2 >�C� L' AM —PM _ - BLD Location1"2,36 Suite MEC Contact Person �— _ Ph �o - PLM _ Contractor _ Ph _ SWR BUILDING - Tenant/Owner C-1 L4 Retaining Wall El R Footing Acce s: Foundation < t` FPS Fig Drain _ SGN Crawl Drain Inspection Notes: Slab -.--..-.—. - SIT _ Post& Beam - Ext Sheath/Shear _- Int Sheath/Shear Framing ----._�s - - _---�_-- -- ---- ------ -- Insulation Drywail Nailing - Firewall Fire Sprinkler _-- -__-_- Fire Alarm Susp'd Ceiling ---- P.00f Misc: Final PASS PART FAIL --- --- --- - ---- - ------ _- PLUMBING ----- - -- _— ---- -- -- - Post&Beam Under Slab i op Out Water Service Sanitary Sewer Rain Drains Fina' PA.S3 PART FAIL - ----- -- -- - MECHANICAL j Post& Beam - -- - _-- - Rough In Gas Line ---- Smoke Dernpe;s Final ----_-._-- -_._.�- ---- -- PASS PART FAIL ag_CT CALF- -- - 'e cri71de___ jJ - --- - - -_. Rough In ' UG/Slab -.�--. �- --- - - Low Voltage FiISSS Alarm _. . _----__--- - -- -- RT FAIL - - - Bach ill/Grading �- Sanit try Sewer Storr i Drain ( )Reinspection fee of$-__��_required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Cp'.ch Basin Unable to Inspect-no a^cess n.re Supply Line ( ] Please call for reinspeMinn RF: _ [ ) p i ADA Approach/Sidewalk Date3 - Inspector Ext Other Final -- ----- PASS— PART FAIL_ i DO NOT REi11 U E this inspection vecord from the ;lab site. A CITY O F TIC'�►R D ELECTRICAL PERMIT / PERMIT#: ELC2000-00125 DEVELOPMENT SERVICES DATE ISSUED: 03/22/2000 13125 SW Hall Blvd-Tipard, OR 97223 (503) 639-4171 PARCEL: 2S110CC-20900 SITE ADDRESS: 12364 SW KING GEORGi DR SUBDIVISION: KING CITY NO. .5 ZONING: BLOCK: LOT : 086 JURISDICTION: KIN Proiect Description: Electrical alteration _RESIDENTIAL UN_ ITTEMP SRVCfFEEDERS _ MISCELLANEOUS _ 1000 SF OR LESS: - 0 - 200 amp: PUMP/IRRIGATION: EACH ADD1. 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HMI SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE!FEEDER BRANCH CIRCUITS -- _ ADD'L INSPECTIONS 0 - 200 amp: W/SERVICE OR FEEDER: i OER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: _ _- _ PLAN REVIEW SECTION 1000+ amplvolt: >=4 RES UNITS: - > 600 VOLT NOMINAL: Reconnect only: SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: JOELLE I " '/ STREAMLINE ELECTRICAL 12364 SW AG GEORGE 6017-B EAST 18TH STREET KING CITY, OR 97224 VANCOUVER, WA 98 Phone: Phone: 360-993-5080 Reg #: LIC 116514 ELE 34-432C SUP 21975 FEE_S__ __ _ Requi, -d Inspections Type - By Date Amount Receipt Elect'I Service PRMT BON 03/22/2000 $42.85 0000850 Elect'I Final ORIGINAL 5PCT BON 03/22/2000 $3.43 0000850 Total $46.28 This Permit is issued subject to the regulations contained in the Tigard Municipal Code,Stats 1R Specialty Codes and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if w,,',,s 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 by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules urdirect questions to OUNC at(503) 246-1987 PERMITTEE'S SIGNATURE ? 2�� ISSUED BY: k �_ OWN R INSTALLATION ONLY _. The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: __- _ _- _ DATE: _ CONTRACTOR INSTALLATION SIGNATURE OF SUPR. ELEC'N: ( Y-� �' �Q��`� ` DATE:__-_ LICENSE NO: _.--_-_--- --- -— ---- Call 639-4175 by 7:00pm for an inspection the next buiciness day 03/21/2000 05: 37 1'3609935082 STRFAW INE ELECTRIC PAGE 02 �r J06119 1103-224-1446 R.2 my Or TIGARD F%f%Chad 1]126 SW HALL OLVD. Electrical Permit Application Keeo br Owtw R0C'd 1 _ TIGARO OR 97222 Date tC a E Phone(303)6394 17 1,tr3(N Dea to DET_ InspecWn(503)639-4175 Prml of Type Fox(503)496.1960 Incoff"M M IMeg"Ife wfp not be see*~ COusd — 1.—Job Aftwj: I. Complete ISM Schedub Bebw: i MW IWW of kop ooft pR p Mft ON@ 'go Name(or name of buslnose) .70 t_t+—a' j� 'j� Swk4 Included: kws Cwt Qum Address _ .3S.z`L�,al._LGA C 1 V�l? I<'C as, Iae"181 pw vn t low eq R a kee s 11718 4 Pad,edd-henel SW eq R d, Qp1 Donlon'rwMN _ i 210,79 t Lon.mMtW FNId4rf10168I lrrRldEnwyt —S 00.00 �� Fed%4w and""a of unduav 24. Con&ncibr In WaNah only: Dweelne 9erv,ce a FaNwr -- s 72 r9 - 2 (Prior to partM twuwnu,plpecetlle mw1 plat, oatrseMl li all Y 6MacM or oleadwe Intw"Wen ter COT daW bowwl 'rnuwlron,0106ton,W rvroeebw. EWdncal Con'twoor 4 E:T R ILt 20U.mos of IM. s no tR ? ped �r r�_ I I 2or omw to Uto trmoe t {e 10 2 City sot em{%10 NOW"* e---{ 129 86 � 2 1 —State _ —zt'..--r�''"�— so .rnp to to�0 mms _ 1 re?60 2 Ow,1001 eros or v0 is _ 1 31175 _ 2 Job No 1 93 n0 - 2 LLC COW 1108 Ne / E>m Ds1e k Twwleorin 01"Vk"or Peso" r - Op Stale CCB Reg.Nay �a E.xp�e 0 1.161101100 •is,1110. m r.lnr-Ator CW Buelne"Tau a Men No _SII .0101 ton�IV 4wW _ - 1 also � ? �• 2ot tn .nw. s e0ae 2 _,/- �/ 001 rape to am emee { lot on 2 Signs u e d S11pr Elec'n-u-ted os.r Ron amps,"low Volk llosM10 NO ( E tD.uMs_LY�1J Od Hench Ckeuld Phone NO ` �.`�d�_-.��.. . ._.�_- Nev.AM OW or eAerMen W penM p)TM%a fm hrondl UTINte 2b. for owner Jnabflpdons: so erfe"""e.9WV" 4woer Ree. PnntOwners Norm _ __ FworArerlrelelon _ III The No for eramh rmilis ,,h, teedor ns, �- � __.. 41818 G Y- MoneNa ernll'wlcrlorare E !t!o T►+e lnsls o0on os being meds On W0011M I own wftltit ra rid r Mb4*1Mrwle 1n1onrled IOr IMe,lel>re or rent (Seroma a lreaur rim r oLaral .7 1s C och pump o ti ee eh ngon d6c1a f _ EwWr 0,n$Mgft No" -` 1 u to r S"st CIMIA14,0,.tkllod matt penes wwai an m exon c eo Ori _ �. Plea ROVIOW 4CHO"(1I required): MW,er Lolmm IIn) -� /to A0 _- Ptsus el,oek eppmpe..eM IMM and 0 IN foo kt Oil IN N.Eseh e@d1#ei l InspscAon evwr reebwMui un"1n one ePueuwr M Nlawt lie In wry d 1011111neove �. hrrnlpwtrlerr 1 5000 WAS ena Idedl.r 726 emte o'rt10I ►�tour - 1 60W _SYlem over 900 vob n0m1n41 In pklnl - --._- _-. C1696ftO ares or sdvcbm come nrg srrrewl ecerlpancy u / _ HowMw 10 o cll.plwr s OR Fes: r M1. togrl er wevw Nee E AuMnR?wee or ptwro ata/wponclell�06%wiry d oto 01eere apply I 9urdlorer((1S w 18181 1`044) IWl tea:rrrre for ternpowry eonlw.lwen wxvkee 'T Iw.rr { Ns rnur 79%of Mne 4 for NOTICE- ►o1 Revew Iyjp"(Sec 3) PERMITS IECOME v040 1f`kORK OR CON"UCTK)N AUTHORIZED IS NOT COMMEWFD 1MTNIN tPC DAYS OR Ir c olisrRUCTICN UR Tv1 Aaswnl e_ �� %WIRK 16 5URPEPOED OR AMANUONED FOR A PE11tO0 OF lit DAYS At ANY TIMI:APER WORK 17 COWENCED I'tyw bear"die i'dllrr r0rm14kttnr dot KING CITY 16300 S.W. 116th Avenue,Ring City Oregon 9722.1-2693 �o Phone:(603)639.4082•FAX(503)639.3771 Notice To Contractors Working An King City Due to an intergovernmental agreement with the City of Tigard, many building related permits for p-Z)jects in Kinn; City are issued and inspected by the City of Tigard. If your permit application DOES NOT REQUIF.E PLAN REVIEW, simply complete the appropriate application legibly and submit it to the King City staff. The King City staff will collect all fees and fax the application to the Cit;; of Tigard. City of Tigard staff will then create the permit, issue the permit, and perform inspections. Please indicate on the permit application whether you would like the Tigard staff to call you when the permit is ready for issuance or whether you prefer it to be mailed without any notification. Any incomplete or illegible application will be retumed to King City staff for correction and no processing will occur until a complete, legible application is received. If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a King City staff person. King City staff will simple sign this form indicating land use approval. Take this signed form to the City of Tigard Development Services Counter located at 13125 SW Hall Blvd, Tigard. to submit applications and plans. Development Services Technicians are available at 639-4171 Ext. 304 should you have any questions concerning submittal renuirem::nts. All permit fees will be assessed and :ollected at the City of Tigard. The City of King City hereby authorizes applicant to pursue permits at the City of Tigard Building Department for the following project: t�&C• k{t1Sw located at:f _ -- = Ing City R resentatiye t n,rs :t�armc CITYOF T I GA R DV MECHANICAL PERMIT DEVELOPMENT SERVICES �Pz/;�� PERMIT#: MEC2000-00067 '3125 SW Hali Blvd., Tigard, OR 97223 (503) 639-4171 x 115 PARCEL: 1S11000-20900 DATE ISSUED: 3/3/00 �j SITE ADDRESS: 12364 SW KING GEORGE DR ff�� SUBDIVISION: KING CITY NO 5 ZONING: BLOCK: LOT: 086 JURISDICTION: KIN CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 DENTS W/O APPL: VENT SYSTEMS: STORIES: _ BOILERS/COMPRESSORS HOODS: _ FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: CLO DRYERS: S: FURN < 190K RTU: 1 AIR HANDLING UNITS C OTHER UNITS: 1 FURN >=100K BTU: <= 10000 cfm: — GAS OUTLETS: 1 > 10000 cfm: Remarks: Installation of furnace, vent riot included with appliance, Sas piping and new gas fireplace. Owner: ��---_ _ y __ FEES _ --- JCEL LEWIS Type By Date Amount Receipt- 12364 SW KING GEORGE PRMT DEB 3/3/00 $50.00 KING CITY KING CITY, OR 97224 5PCT DEB 3/3/00 $400 KING CITY Phone: Total � $54.00 ----- --- Contractor: BELL i'EATING (GREG MILLETT) 15550 SE PIAZZA AVE REQUIRED INSPECTIONS CLACKAMAS, OR 97015 T � — Gas Line Insp Phone:656-1184 Mechanical Insp deg #: LIC 447 Heating Unt Insp PLM 3-286PB Cooling Unt Insp Misc. Inspection 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. You may obtain copies of these rulep or direct questions to OUNC by calling (50,3)246-9189. Issue BY' �� Permittee Signature Call (503) 639-1175 by 7:00 P.M. for inspections needed the next business day W-03700 F RI 02.58 FMy +. Ki:I c;'.+.y FAX.503 639 3771 PAGE 2 <11 3soA x ') / 40 Plan Check 8� CITY OF TIGARD Mechanical Permit Application Rec%8v 13125 SW HALL BLVD. Commercial and Residential Date kec'd TIGARD, OR 97223 Date to P.E. (503) 639-4171, X304 Date to DST-LA- Print or Type Permit Incomplete or Illegible applications will not be accepted called ---- 9 PP ._ P Name of beveloorronnv mixt— - Description �i d* Table to Mechanical Code Cty Price Amt CO Jab A Permit Fee — 10.00i west s sulfas 1__.. _ _ C'oi C� 1) Furnace to 100,000 BTU Address /2 3��/ S lv /{�� G } _ including ducts 6 vents 40 Wa 9' aiagx clylstahr V Zip 2) Fumace 100,000 BTU4 le: (', includin ducts 3 vents 7,50 Name(or named bualraaa) 3) Floor Furnace a IncludinC went 6,00 Owner 4)Suspcnded heater,wall heater Manny nddrwc or floor maunted heater 6.00 /13L Sw ,,,, 5) Vent not Included in appliance pniTnh cryrstete ?IP Phona-7 �•r CHEC:ALL *Hailer Heat Air 1HAT APPLY: or i",Amp Cond ON Price And N ry-rwrrtw bf xtrlesa) __ Con10 _ 8)<SHP:absorb unit fu Occupant 1AeIIInp Addteaa -� 1`01K BTU 7)3-15 HP;absorb unit rnyrsle+e IIP Phase 1001,to 500k B1 U__ - 11.00 8)15-30 HP;absorb uiln .5.1 mil BTU _ 15.00 - Contractor N ` --4)-T6-_65 HP;absorb -.h 1.1.75 trill BTU 22.50 Pflorto per,,,p Maltirig Adrrtraa 10)>5011P absorb unit Muence a copy /_S50 3"F Aort _ X1.75 mil BTU of all Iho3nses CRyr3tme ZIP Phone 11)Air handling unit to 10,000 CFM aro required If 471e,-e4- -S On /rf GG//a-/ — --- 4,60 expired In GOT Cnnat.Corp,Sna,d 1_le 0EM 081A12)A_--handfing unit 10,000 CFM t database 1.50 ArChFtect Name 13)Non-portable evapora(A cooler 4.5U rNa�finp�dGrea— '-- 14)Vent fan conn9cleti to a single dud or 3.00 ___ __� 15)Ventilation system not included M En �gtncor � 'ar^ zp I r'nO"e appliat,re permit 4.50 16)Hood served by mechanical exhaust --_.�.__._• - - -- --- -- __ 4.50 D,'ucsfbe wo.*to be done' - ---- 17)Deme.4tic Incnemtom New O Repair O Repintr.with like kiivJ: Yrs O No 0 __ _ 7.50 nesidentimo Corntnerrlal CU 18)Commercial or industrial typo Incinerator _ 30.00 Addilianal Infem►aHon or description cel work; ' 1?)Repair units_ - - _ 20j Wood stave 4.50 21)Clothes dryer,etc. _ 4.50 22j Other units �-----�--�_ _ � Type of fuel- oil O natural gas l_rG O electric O 4.50 /'S I hereby seknowkrctge that I have read this eppllailon,that the inform,tion 23)Gas piping okd to four lets given H tuned,that I cart the owner or authorized agent of _ _ _ ------- 2.00 , the owner,that plans submitted are in compliance with Ore con State laws 24)More than 4-per outk,t(each) "nature of n Owor/Agert Date Minimum Permit Fee SUBTOTAL 07 l- �-ow 79k SURCI,,AkGE � 1 Centad Person ams - Phone --- ht AN REVIEW 25%OF SUHTOTAL Requlmd for ALL commercial Pnrmlta nn! 'OV AL :State Contractor Boiler Certfiicatron teyvim,' •'Resldenllal AIC requires site plan shm��n►I placnmont�f unit hYnechpenn.doc rev 07/20!88 /��