10660 SW NORTH DAKOTA STREET-1 a •
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CITY OF TIGARD BUIL�INTION NO1 'E ?t4f
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171 A.
j Inspection:
Footing Susp. Ceiling Sprink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab : eecc Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out .E c_Roug_h_-�' ) FINAL:
Post/Beam Mech. San. Sewer was Lined -Bldg.
Plbg. Underfloor Rain Drain Framing CPlum�it ` �1 •
Alarma er L:in:0 Insulation ech.
Unde,flr. Insul. Shear Wall Gyp. Bd. -Elect �v
/ O \ `
Date Requested: ( Z I f-�� Time: AM `� PM
Address: �J C/ 1�=�..L,z C�
Builder: Permit#:ft74:-C ct'S—y3 W
THE FOLLOWING CORRECTIONS ARE REQUIRED: (A ( 5 - C'357
Inspector: _ Date:
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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PERM.I T
CITY OF TIGARD DA TEI ISSUED: 11/21E995-1 394
COMMUNITY DEVELOPMENT DEPARTMENT •
13125 SW Hall Blvd.Tigard,Oregon 97223.8799 (503)839-4171 PARCEL: 1 S 134DA-0 800
iITL (1DlJFtEt `�„ . . JOu t'i 'lW NORTH lilil'•UlA S1
SUBDIVISION. . . . : ZONING: R--3. 5
BLOCK. . . . . . . . . . . LOI.. . . . . . . . . . . . . .
_`- - - J�-v-- - -- Y µ M-
CLASS O WORK— : .�be . rCV�FCOO_ERS: 0 _
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
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OCCUPANCY GRP. . : R3 VENTS Wi O Alc'E='L: 17, VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 LAO ILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL_ 'TYP'F_S---.-----•--.-- 0-3 HP. . . . : 0 DOMES. I NC I N- 0
. 3-15 HF'. . . . . 0 COMML. INCIN: 0
MAX INPUT: 0 RTU 15-30 HP. . . . : 0 REPAIR UNITS: 0 �
FI RE. DAMPERS'. . : 30--50 HP. . . . : 0 WOODwTOVES. . : 0
GAS PRESSURE. . . . `i0+ HP. . . . . 0 (:LO DRYERS. . : 0
NO. OF UNI"(5------ --- A 1 R HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K PTL): 1 <- 10000 cf•m : 0 GAS OUTLET'S. : 1. `
TURN ) =100K SITU: 0 ) 10000 cfm: 0
Remar,ks : Install. fr.irnace, gas piping
Owner: -_.._.____.___..._._._._______._._..___...__.__.___-----___ __._._._..___--- FEES ---•-.__--_-_--_
JOHN [)ACID, type zmol.tnt by date r,ecpt:
10660 SW NOR-rH DAKOTA ST PRMT $ 5. 00 JSD :11/21/95 95-273125
5PCT $ 1- 1-215 JGD 11/21/95 95 '2731 c:`.1
TIGARD OR 97223
Phune #:
Contractor,:
ENERGY MASTERS INC
;470 SW 76 1-H
PORTLAND OR 97223
Phone #: "?44-f:3E3Ei0 $ 26. 2'5 TOTAL
Reg #. . : 58556
------- REQUIRF_D INSPECT IONS
This permit is issued subject to the reoulations contained in the Ihechanir,al Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
f applicable laws. All work will be done in accordance with _ __- �- ��- -� kt
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,
Per-in itstee `- j t.ir ;kt. '.r;
Issr.led By • , ( t ccT
Call for, inspection - 639--4175
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City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Hall Blvd. APPLICATION Permit # 41E� 3`�< � � •
1
Tigard, OR 97223 `
(503) 639-4171 .� /
Description
Table 3A Mechanical Code QTY PRICE AMT
Job �O�j�D S(,(/, �t C�1LJ -j J 1) Permit Fee -0- -0- 10.00
Address •°
.Z 2) Supplemental Permit 3.00
""""" "'° °'"°••' urnacet--to 1 .000 BTU
Jots' ��Ctk 1) incl. ducts 3 vents 6.00
Furnace + —
Owner 2) incl. ducts 3 vents 7 50
r'srr'
Floor Furnance
3) incl. vent 600
......' Suspended heater, wa I he3ter
"— 4) or floor mounted heater 6,00
' • ""• keno not incl. in
Occupant 5) appliance permit 3.00
�`_ epair o eating, re rig.
6) cooling, absorption unit 6.00
Boiler or comp, heat pump, air con
PiII,J ta(tel N1 �� j �'( .1 to 3 HP, absorp unit to 100K BTU 6.00 p
• o ""• of er or comp, eat pump, air con
Contractor -747G) S`�' 7 6 244 8) 3-15 HP; absorp unit to 50oK BTU 1 t0U
-7 p Boiler or comp, heat purnp, au con
9) 15-30 HP; absorp unit .5-1 and BTU 15.00
Boiler or comp, heat pump, air con
/;,If z- 60/ 10) 30-50 HP, absorp unit 1.1.75 mil BTU 22.50
ere y ac now a ge that I have read this application, that the Boiler or comp, heat pump, air cond.
information given is correct, that I am the owner or authorized 11) > 50 HP: absorp unit 1.75 mil BTU 37.50
agent of the owner, that , ins submitted are In compliance withit nan ing unit to
State laws, that I am registered with the Construction Contractor's 12) 10.000 CFM 4.50
Board, that the number given is correct. (If exempt from Slate Air an ing unl
registration, please give reason below.) 13) 10.000 CTM + 7 50
Non portable
14) evaporate cooler 450
Vent fan connecte
15) to a single duct 300
anti aeon system not
16) included in appliance permit 4 50
Hood serve y
6 17) mechanical exhaust 4 50
1Se n ewo new addition aeration repair t_1 ommercia or industrial _
to be done residential O non-residential Q 18) type incinerator 30.00
_xlsting use o ( p— tier Le., woo stove. water
building or property (y C1 71. (��U"` _ 19) heater solar, clothes dryers, etc. 4 50
Proposed use of 20) Gas piping one to four outlets 200
building or property _ _ —
21) More than 4-pet outlet (each) 2..00
Type of fuel -oil O natural gas Q LPG O electric (_)
NOTICE
Minimum Fee $�'5 00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION —
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE !
IF CONSTRUCTION OR WORK IS SUSPENDED OR --
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED _.
TOTAL
Special Conditions "�L — f
_ Date issued r y —�—v-- —�
M.LOOIMb9T51MEC1'pMt
Fr
PLUMBING PERMIT
C11Y Oir TIGARD DATE.TISSUED: 11/21/995-0351
COMMUNITY DEVELOPMENT DEPARTMENT '
13126 5W Hall bi-:.Tigard,Oregon 97223.8190 (503)639.4171 PARCEL: 1 S 134DA--02800
SITE ADDRESS. . . _ JJe)6()0 (3W NORTH DALCCJTA `.-,T
SUBDIVISION. . . . : ZONING: R-3. 5
BLOCK. . . . . . . . . . . I_i1T. . . . . . . . . . . . . .
7� ------------------
-------___.—_—_.-__------------____•—•-•.---_..._..
CLASS OF WORK. . :(yP_>rl (J'�" —GARBAGE DISPOSALS. : 0 MOBILE HOME SPACES. . 0
TYNE OF' USE. . . . :5F 7 WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0
OCCUPANCY GRP. . :R:3 FLOOR DRAINS. . . . . . : 0 TRAPS. . . . . . . . . . . . . . . 0
STORIES. . . . . . . . : 0 WA"fER HEATERS. . . . . : 1 CATCH BASINS. . . . . . . 0
LAUNDRY TRAYS. . . . . : +T SF RAIN DRAINS. . . . . 0
e SINKS. . . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE TRAPS. . . . . . . . +7+
I—AVATOR!ES. . . . . : 0 OTHER FIXTURES. . . . : 0
TUB/SHOWERS. . . . : 0 SEWER LINE: (ft ) . . . : 0
+.•LATER CL05ETS. . : 0 WATER L.INI: (ft ) . . . : 0
DISHWASHERS. . . . : 0 RAIN DRAIN (ft) . . . : 0
Remarl(s . wacrar heate•r-
Owner —_______----------______________.__.__ FEES
JOHN OACK type <amor-int by date r,ecpt
10660 SW NORTH DAKOTA ST F,RMT $ 25. 00 J'SD 11/21/95 95-273125
5-F'CT $ 1. :'5 ,TSD 11 /21/95 95•--273125
TIGARD OR 9722-:2
Phone #:
Contractor;
FNERGY MAST1.=R5 INC
7470 SW 76TH
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FORT LAND OR 97223 __ ._._______._.--.--._._-----_—_—_.—_---_—._ y
Phone #: i?44-8880 $ 26. TOTAL._
Rpq #. . : 58556
REQUIRED INSPECTIONS
—This permit is issued subject to the regulations contained in the M i s c. I n s p e c t i o n
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final I n s pect i On
applicable laws. All work will be done in accordance with
aoproyed plans. This permit will expire if work is not started
within 188 days of issuance. or if work is suspended for more
than 180 days.
F'e r m i t t e e S i g n a t u r e p
4 Cal for inspection — 639--4175
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City.of Tigard PLUMBING PERMIT APPLICATION Planck/Rec. #
13125 SW Haul Blvd. Permit # o S^ f
Tigard, OR 97223
(503) 639-4171
MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
" , _,n�� r New Single Family Residences Only
A"-�i7� - I ❑ 1 BATH HOUSE$140.00 L3 2 BATH HOUSE$195.00
Job I�CXI� S. Cl/. /�' C1 3 BATH HOUSE$225.00
Address cMamm zr Fee includes all plumbing fixtures in the dwelling and the first 100 feel
ne CJ ,ZZ 3 of water service, sanitary sewer and storm sewer. See fees below.
N.m.�«°«°.a e°......1 FIXTURES CITY PRICE AMT
Sink 9.00
M.Ihp AOJw.
Ph- Lavatory 9.00 �
Owner Tub or Tub/Shower Comb. 9.00
c.nwn. Shower Only 9.00
Water Closet 9.00
N.m.W Dishwasher
9.00
Slaw Garbage Disposal 9.00
Occupant MYny as-. A°"• Washing Machine 9.00
Floor Dram 9.00
b Water Heater 9.00
c:xvm«. _
Laundry Room Tray 9.00
N. Urinal 9.00
fZ('f� /Yf/�f rj' �LS (� Other Fixtures (Specify) 9.00
M.*,a Ad&- o�.°. 9.00
Contractor -7 470 9.00 -
zip 9.00
Sewer 1st 100' - 30.00
MO.R.°.°.n«,No civ a. r..;7 Sewer-ea. Addit. 100' 25.00
ri (3S,5(, Water Service 1st 100' 30.00
I hereby acknowledge that I have read this application, that the Water Service ea Addit. 200' 25.00 4
information given is correct, that I am the owner or authorized agent of - 1
the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.00
1 am registered with the Construction Contractor's Board, that the Storm d Rain Drain Addit. 100' 25.00
number given is correct. (If exempt from State registration, please
- Mobile Hoare Space 25.00
give reason below.)
Back Flow Prevention
ice or Anti-Pollution Device 9.00
/ :y Trap or Waste Not
Connected to a Fixture 900
De.cube woo new 0 addition Q alteration repair Q Catch Basin 9.00
to be done residential O non-residential ( Irsp. of Exist. Plumbing 40.00/hr
Specially Requested Inspections 40.00/hr
Existing use of 7i 1 re Rain Drain, single family dwelling 3000
building or property .}- V 1`'� --
Residential backflow prevention
devices 15.00
Proposed use of
building or property -_ .(Except residentlef backflowv
prevention devices)
NOTICE 'Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMEN^.EL` WITHIN 180 DAYS, OR IF 5%SURCHARGE
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED - -
FOR A PERIOD OF 180 DAYS Air ANY TIME AFTER WORK IS
FLAN REVIEW 25% OF SUBTOTAL
COMMENCED
TOTAL
Special Conditions -
Date issued by
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