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CITN' OF TICARD 2{-Hour
BUILDING inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST _
Q' BUP —
Received _ _ Date Requested_— 2 __ AM .PM —_ BUP
Location / ��" G��%t y suite
Contact Person Ph(_ ) 2: < 5 ��: OLM
Contractor_____ _ V Ph( ) — SWR —
BUILDING —� TenanUr4.w:r����"�'`C �rnQ-'2.Ov�� — ELC
Fovung (I 1
Foundation 3 O ELC _
Ftg Drain Acces':
Crawl Drain1--yt�t/� E..R _----___ --
Slab Inspection Notes: �nn/ _ SIT
Post& Beam
Shoar Anchors — — —•— — --
Ext Sheath/Shear
Int Sheath/Shear —
Framing 111= -- ----
Insule.iion `n/
Drywall Nailing V rAl�,t�f,`Y�-
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling ------ -- - - ------- --
Roof
Other: - --- -- - -- - — --- -- —----
Final ------PASS PART PART FAIL _ -- --
PLUMSIN4 — -- ,rL ----Y-' _ -- -------
Post& Beam
Under Slab
Rouk,�hdn
Water Service
Sanitary Sewer _
Rain Drains --- - - --
Catch Basin/Manhole
Storm Drain ----- - ---- __ __
Shower Pan
Other. ------__ ._.__--
Final ---_ - ---
PASrS...PA -FAIL-----
TT ---- — ----- - - —.
S
AL _ --
Post& Beam
Rou h In
Smoke Dampers
rIP3 B N PART FAIL ----- --------------- --- — --- ------
LEto' ICAL _
Service — —
Rough-Ir,
Ur,/Slab ___ - -------- ---- ----_
Low Voltage
Fire Alarm
Final Reinspection rreins
e of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
PASS PART FAIL SIT F] Please call f pe ion RE .___ _ -- Unable to inspect-no access
Fire Supply Line
ADA
App-oach/Sidewalk Date — Inspector _.- ---_--------- _---_ Ext
Other:
mal — DON T REMOVE this Inspection irecord ftror;,w the Jab site.
PASS PART FAIL
CITYOF T I CSA R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2004-00785
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/3/20
PARCEL: 2S 10404AA-07600
SITE ADDRESS: 12715 SW KATHERINE ST
SUBDIVISION: BELLV'.•OOD NO. 2 ZONING: R-4.5
BLOCK: LOT: 109 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUFANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: _BOILERS/COMPRESSORS FlOODS:
_ FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 15 HP: COMML. INCIN:
MAX II,!"-1 f: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
FURN >=100K BTU: <= 10000 cfm OTHER GAS OSUNITS:
OUTLETS:
> 10000 cfm:
Remarks: Replace electric w/gas IOrnace.
Owner: _ FEES
CAMERON, DOUGLAS Description Date Amount
12715 SW KA-I FIERINE ST l%II c III I'vrmit I;ce 12/3/2002 ! $72.50
TIGARD, OR 97223 I \\I `t Staic surchar} 12/3/2002 $5.80
Total $78.30
Phone: 503-330-7807 L ---
Contractor:
ABLE HEATING &COOLING INC
12420 SW SUMMERCREST DR
TIcUARD, O� 97223 REQUIRED INSPECTIONS
Phone: 503-579-2250 Heating Unt Insp
Final Inspection
Reg #: LIC 108535
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Coes
and all other applicable laws. All work will be clone in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, oi 4 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 4(e set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain copies of these rules o[xiir ct,g6esliors to OUNC by calling
(50:0246-6699.
Issued By: rf_ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
► . Rcoeived
If" of.lI Igard IhtolBy: �� 'i` femme No.: d y /
13125 SW Flail Blvd.,Tigard,OR 97223 Plen Review
Phone: 503.639.4171 Fax: 503.598.1960 Ihac Fiy. Other Petmit:
Inspection Line: 503.639.4175
Internet: www,cr:igard.or.us Dale Readv/f1y: tuft►: ® See Page 2 f)r
NolilieaLMethod: Supplrmentdlnformathm
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑New construction Q]Addition/alto;dtion/replacement — Mechanical permit Ices'are bast;on the value of the work
f❑ performed.Indicate'�le value(rcar,ied to the nearest dollar)of all
El Demolition Other: mechanical matenals,equipment,labor,overhead,and fit.
CATEGORY OF CONSTRUCTION — Value:S
❑ I-and 2-family dwelling ❑Commercial/industrial ❑ RESIDENTIAL EQUIPMENT/SYSTEMS FEES*Accessory building
❑Multi-family _ l'Or special information use checklist.
Master builder ❑Other: —�—_- Description _ city. I, thiel
JOB SITE INFORMATION AND LOCATION Hestin coolin
Air conditioning or neat pump I I I I
City/Statc/Z1P: _ 1 4— 1'wnauenll/U,111111tiIlJ(duotNvents 14.W (yp�;
Saite/bldg./apt..no.: Project name: Furnace 100,000+BTIJ(ductsrvents) 17,90
-- Gas heat pump. 14.00
Cross strcei/directions to job site: rAxt work 14.00
— T-- ------ Hvdi mic hot water system 14.00
� __._, .-. -- ---..Y_- I fI tncirimtinlM.IrtrtrnriirNrxlr -
by lu it n 14 on ,
-`_-- ----------- -- -- Unit heaters(fuel-type.not electric).
in-wall,in-duct,suspended,etc. 10.00
Subdivision: !_ ot no. !_ ---� Fluc/vcnl for any of above 10.00 10, O'k
_-- -- Other 10.00
Tax map/parcel no.: --_ — Other t4rel• lienees
` DESCRIPTION OF WORK Water heater - 10.00
� �e- (ins fir lace 10.00 Fluc vent for water heater or h
firL
Tlace_ _10-00
--------- — -- --- ---------- 1, h ter as) 10.00
—__-_ -- - -
woodqieliet stove 10.00
Wood fi lace/insert 10.00
PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10,00
Name: -- - -- (Rhee � _ 10.00
c W✓t-)tr(.3 tri Environmental exhaust and ventilation
Address: - --- Range hood/other kitchen
equipment
10.00
City/StaWZIP: Clothes dryerExhaust 10.00
Single-duct exhaust(bathrooms,
Phone:(��2 1 � � -7 Pi Fac ( ) toilet compartments,utility raom_m 6.80
❑ APPLICAN. ❑ CONTACT PERSON Atdc/crawls'La ce fens
— - - 10.00
— I t
Fuel ploinst
Costed name: —�- -_-- 38.40 for flro fi)ar 51.00 for tewh additional
Address: --- Furnace,etc.
---- - --- (las hea_1 pump
City/State/ZIP; - -_ WRII/susLyenidoWunit heater
Phone:( ) A A I 'ax: :( 1 — - Water heater
E-tttail:
--_.- - -- Firelacc
Ran&c --- -
iCOMMtACTOR Barbecue _
Business name: � S „ `I `1 v Other: cr s)
Address 1 a.Wau MECHANICAL—PLRMIT FEES•
CifvJCfntrJRIPI 1. C •� u - I I _ Subtotal I �;ZCTLt I
_h4inimum
Phone:(5t,Zj) c �'0 Fax:(A), ) �� `Cl`C)� _ Fxmnit fee($72,50)
f") �l
Plnn rrvirw(2 50".of permit frr)
CCB lic.: Ufa —State surcharge(8%of permit fee)
_ TOTAL PERMIT FIN Jr d
Authorized/ alarC: `�—" Ihl�permit�ppllceHon r%nlreq If a prrmlt not ohfe111ld wIMIMt leo
r--~— _ dna filter It ha►b -n mounted as rumnlete.
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