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i:\records\micro(Im\targets\t)uilding.doc
CITY OF TIGARD MECHANICAL
PERM.C'T
COMMUNITY DEVELOPMENT DEPARTMENT I",ERMi"I' ;f#. . . . . . . : MEC95--0f ,
13125 SW Hell Blvd.Tigard,Oregon 97223@8199 (503)839-4171 DATE ISSUED: 04/15/95
PARCEL: 1 S 1,.6 C B-08600
!RD I V 16 I ON. . . , HERB & PEGGYS PLACE ZONING: R-4. 5
t]CY,. . . . . . . . . .
L 0T. . . ... . . . . . . . . :26
I -ASS OF WORI"%. . :ALT rt_,OOR FURN. . . . : EVAr COOLERS:
'1'",E OF USE. . . . :SF UNIT HEATER-,. . : VENT FANS. . . _
Q JPANCY GRP. . : R3 V[-r'dTG W/0 nP1-,L: VENT SYSTEMS:
DRIES. . . . , . . . .. i DOILERS/COMPRESSORS, HOODS. . . . . . . .
!17.1.. __. 0-3 ;..Ips. . . . : DOMES. INCIN
SRS/ / / 3-1:` HP. . . . : COMi+1L. INCIN:
A INPUT: DTU 1: —30 11P. . . . : F?EPA I R UNITS -,
RE DP;hPERS?. . : 30 -SVI Hf-'. . . . : WOODSTOVE.;. .
HP. . . . : CLO DRYER;. . a
OF UNITS--•------ - PIR HANDLING UNIT, OTHER UNITS. : 1
RN ( I.001i STU: 1 ( 117_CL4"0 c ria : Cis" OUTI__L T^. : .i
?RN ) -100K P"['U: > 100Co CFM:
marks;: Acid I gas f� v-nac:e sand 1. gas VJiter' heate1^ and gas p.1p1ny
1
[-EES __ _........__ ._..
INIEL DEES type .'am!31.mt Icy d-A r,er,pt
084 SW S1ST PRMT $ 25. 1410 JDA 04!15/95 -
SF C T
1. 25 JD(I 04 i 15/95
3ARD OR 97; x..
REQUIRED I 7^r,f C'f IONS
This Pet-lit is issued subject to t'.,e regulations contained in the Gas; Lane InSp
i igard Municipal Code, State of O e. Specialty Codes and all other Mec:han i r:a 1 1 n s p
applicable Iaws. All work will 11e done in accordance with Final Insper_ticln
app-oved olal s. This permit will expire if wc-rk is not started
within 180 da,s of iseeanr_e, or if work is s.spended for #ore
than 180 days.
pct 1 In i+.:l r--.,e r i �ri� t ., • ? �tLtiL� t� . s�2/ M�u�--�-__ ,..._..�.�_.____.-. .�__._w.�__._._..__,__..._. __..:_...
C'ol t. for inspec:tian 639-4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Han Blvd. APPLICATION Permit # PC
Tigard, OR 97223
(503) 639-4171
escnpuon
Table 3A Mechanical Code CITY PRICE AMT
Job l G(kJ s;
r 1) Permit Fee -0- -0- 10.00
Address --ap
-Tlcjlp, 02- 2 3 2) Supplemental Permit 3.00
urnao i
—T
--
DAN I L L 1) incl. ducts&vents 6.00
•M urnace 100,000 BTU +
Owner 7.^•M If 2) incl. ducts&vents 7.50
Floor Furnanco
3) incl. vent 6.00
uspen eat�Fieater, --
4) or floor mounted heater 6.00
Occupant Vent not mnc. in (`
5) appliance permit 3.00
Lp Repair o eating,re—Tg-
6) cooling,absorption unit 6.00
i er or comp,heat purnp, atr con .
7) to 3 HP;ab�;orp unit to 100K BTU 6.00
w i er oompTeapump, air cand,
Contractor 8) 3-15 HP; absorp unit to 500K BTU 11.00
ap boder orcomp, hea pump,air cand.
9) 15-30 HP;absorp unit .5-1 mil BTU 15.00
'•'°^ •^ BMW or comp,heat pump,air con .
10) 30-50 HP;absorp unit 1-1.75 mil BTIJ 22.50
hereby acknowliitlgo that ve read is application, that e Boiler or comp,heat pump,air con
information given is correct, that I am the owner or authorized agent 11) > P,0 HP;absorp unit 1.75 mil BTU 37.50
of the owner, that plans submitted are in compliance with State r handling unit to — —
laws hat I am registered with the Construction Contractor's Board, 12% 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, irYan-fFin g uni
pleas_ give mason below.) 13) 10,000 CTM+ 7.50
— mon portable — —
14) evaporate cooler 4.50
Vent ar'connect - -
15) to a single duct 3.00
enu a',oc sisystem not
16) included in appliance permit 4.50
Hood seryy —_
17) mechanical exhaust 4.50
escn a work nev addition U a terauon W repair ++ �ornmercia or industrial
to be done residential O non-residential O -I 18) type incinerator I 30.00
•xis mT g use of — er i.e.,woo s ove,water I—
building or property 19) heater, solar,clothes dryers, etc. 4.50 �•f Z'
- Proposed use of 20) Gas piping one to four outiels r 2.00
building or property
Type of fuel oil Onatural gas� LPG O electric � 21) More than 4-per outlet
NOTICE
Minimum Fee$25.00 SUBTOTAL 7 �)
PERMITS BrCOME VOID IF WORK JR CONSTRUCTION
AUTHOgIZED IS NOT COMMENCED WITHIN 180 DAYS.OR 5%SURCHARGE 1
IF CONSTRUt;•.ION OR WORK IS SUSPENDED OR ---
ABANDC JED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED -- 11
TOTAL ��' ✓I
Special Conditions
Dare issued by {�
M•MEqPMt
..wrm�fw
Perinit #:
Address:
i IsSU^d by: __- -- - — Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.0s.'17(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing peanuts. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes I and 2 and either box 3A or 313:
1. 1 own, reside in, or will reside in the completed structure.
2. 1 understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
(� 3A. My general contractor is
t _�1 (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
,? 1 hereby certify that the above information is corre,t and that 1 have read and do understand the ltil'ot mation
Notice to Property Owners about Construction Responsibilities on the reverse side ri'this form.
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
CITY 017 TILARD - wcripi nFPnYMFNT RECFIP7 NO. a 95 --P642.63,
CHf--.CK AMOUNT a 815. 00
NAME a DANIPL DEES ("A,314 AMOUNT a 1. '-.5
ADDRESS a 11084 SW HIST PAYMENT DATE a 04/17/95
SUBDIVISION
TIG'ARD, ON 97;'IIP3--
V.,I,lRr:,OSE OF 1,(.iYM(7.N,r (M)TINT PAID PURPOSE OF PAYMENT AMnUNT PAID
f m F* rp-0 0 n 5 I?t-). 00 St. SLITID PER 1. P5
AnUTN(i WIS WIITF--P HEATER AND FLIP14A(.-,L-
10TAL AMOUN1 PAID
Z2�_ _
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling Plum
Post/Seam Mach. Shear/Sheath Framing
PIbg.Und/Fir/Slab Plbg. Top Out Insulation -Elect.
Post/Beam Struct. Mach. Rough-in Gyp. Bd. -Bldg
San. Sewer Gas Line Appr/Sdwlk Reins.
Other:
Date: A.M. P.M. Entry:
Address:
Tenant: ` Ste: MST:
BUP:
Con/Own: A.4 MEC:
vZO (0S7 ELC - —.
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
a _
ft
a-
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CD --
LLJ
InspFrto�� l Date
A
PROVED -DISAPPROVED/CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling Sprink. Rou -in Appr/Sdwlk
Foundation Plbg. Undersla5 . Rough-in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough-in FINAL:
Post/Beam Mech. San. Sewer Gas s_~' -Bldg.
Plbg. Underfloor Rain Drain Framing -Plumb.
Alarm Water Line Insulation -Meth.
Underflr. Insul. Shear Wall Gyp. Bd. -Elect.
Date Requested: Time:_ZAM PM
Address: I ( � ,� `� _ -1, S.
E3u+MerCFZL 'Z _Permit
THE FOLLOWING CORRECTIONS ARE REOUIRF-D:
A
c
I--
lI')
72-
CM fes] -—
CD
W `
Inspector .� Date:
APPROVED DISAPPROVED k APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection:
Footing Susp. Ceiling S rink. Rough-in Appr/Sdwlk
Foundation Plbg. Underslab Mech. Rough-in Fireplace
Post/Beam Struct, Pfbg. Tcp Out Elec oug -in FINAL:
Poct!Beam Mech' San. Sewer Gas Line Bldg.
P g. Underfloor Rain Drain Framing -Plumb.
Alarrn Water Line Insulation -Mech.
Undertlr. Insul. Shear Wali q Gyp. Bd. -Elect.
Date Requested: (/(G — / Time: AM _ I>M
Address:_ 7
Builder: ,/�GY.r t (/e e-S _Permit#
THE FOLLOWING CORRECTIONS ARE REQUIRED:
i
ka
L
7 '
r�
Inspector: /' Date:—�"`�'`�
APPROVED DISAPPROVED A PROVED SUBJECT TO ABOVE
ze-call For Reinsp.
CITY OF TISARV -- RECElf"r or PAYMENT RECEIPT NO. aih
GHPCK AMOUNT ;'6- 25
NAME t DANIEL Df'7ES CASH f4MOUNT Q;. (10
ADDRESS 3 11084 SW 811ST POYME'N'T VATF 04/21 ,195
sun I v is I aq
TIGARD, OR 1)72121.3-
PURPOSE Or- r_�J)NIMF7NI AMOUNT PAID PURPOSE OF PAYME14T AMOUNT PAID
MFVHANl('nL PE"i MEA7.9tip-0079 2!5. elel PT. BUILD Pt,-R 1. 25
4.1
ADDING NEW WniCR HE70TER
11OA4 SW 81ST
AMOUNT PAID P5
CITY CSF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13126 SW Hall Blvd.Tigard,Oregon 97223.6199 (503)639-4171 PLUMPING PERMIT
PERMIT W. . . . . . . .. PLM9S -0079
639 4171 DATE ISSUED: 04/2J/95
PARCEL: 1 S 136CB-4t8300
ITL ADDRESS. . . I 1081 SW 81ST AYE
'UBDIVISION. . . . : HERB & PEGGY' S PLACE ZONING: R-4. 5
-LOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :26
_L.ASSrOF IJORK. . :�tf GARBAGE — :-DISPOSALS, . .__..._____MOBIL.E HOME SPACES. .M~-~___
TYPE OF USE. . . . -SF WASHING MACH. . . . . . . : BACKFLOW PREVNTRS. . :
CCUPOt',t^Y QRP. . :R3 F1._OoR DRAIPJ^. . . . . . . . TRAPS. . . . . . . . . . . . . . .
•JOR I CS. . . . . . . . : 1 WATER HEATERS. . . . . . : 1 CATCH BASINS. . . . . . . :
... IXTURES - - ___..___ LAUNDRY TRAYS. . . . . . : aF RAIN DRAINS. . . . . :
INKS. . . . . . . . . . : URINALS. . . . . . . . . . . . : GREASE TRAPS. . . . . . . .
._rAVATORIES. . . . . . OTHER FIXTURES. . . . . :
UB/SHOWERS. . . . : SEWER LINE (ft) . . . . :
:�,wTCR CLOSETS. . : WATER LINE (ft ) . . . . :
:)IGHWASHERS. . . . : RAIN DRAIN (ft) . . . . :
'emarkz : Adding new gas wzi,t:er !-teat et,
_)wners _______�_._______..__ _.___.__._.,_._...___..... FEEy
(INIEL DESS ty(ae amount lay date r^ecpt
1084 SW 810T P'RMT $ 25. 00 JDA 04/21/95 --
5PCT 4 1. 25 JDA 04/"`1/')5
rGARD OR 97L2.:, 2443
hcne #:
WNCR
linne ##: $ 26. 25 TOTAL
eg #. . .
REQUIRED INSPECTIONc; ------
iii: perait is issued subject to the -4julations contai-«d in the Mi SC. 1715ptlrt ion
Tigard Municipal Code, State of Ore. Specialty Codes and all other Gay Line
i,'icable laws, A;: work will be d,.ne in accordance with Final Inspection
;13roved plans, 'his perait will expire if wurk is not started
a tthin 188 days of issuance, or if work is suspended for sore
'an 188 days.
F--
i t t e c 3 i ri' ,t I_tr'r
y t.tied LeyLL)
J
CatI t f0t, :Inspection - 639-41745
City of Tigard PLUMBING PERMIT APPLICATION Planck Rec . #
13125 SW Hall Blvd.
Tigard, OR 97223
(503) 639-4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGE
New Sin le Family Resident_ ea Only
Nam•al(HvMoPm.nt
❑ 1 BATH HOUSE$140.00 ❑ 2 BATH HOUSE$195.00
Ad*.a. _ % ❑ 3 BATH HOUSE$225.00
Job lZIP Fee includes all plumbing fixtures in the dwelling and the first 100 feet
Address Gw •
1(4 � � O� q�Z Z 3 �y�' 3 of water service, sanitary sewer and Ston QTM sewer. see fees belAofw�
I FIXTURES
wm.(a nano ei Nanwal 9
Sink
.00
�:�NI �L L 17E �5 9.00
Pnen. Lavatory
MJrq ewer..•
�Ivl Lr Tub or'rub/Shower Comb. 9.00
wner 9.00
O
m Shower Only
cayisraa- 9.00
Water Closet
9.00
Dishwasher
Nan.Io<n.m•o�Uwai•.•I 9.00
rbage Disposal
'�Q Ga
;�lE 9.00
Occupant Washing Machine
9.00
Floor Drain
9.00 �
ao Water Heater L
�,r ame 9.00
Laundry Room Tray
9.00
NWft Urinal 900
n,All
Other Fixtures (Specify)
A 9.00
Phan.
Meft,Ws«a 9.00
Contractor 9.00
5P -
„�,,,.
Sewer 1st 100' 30.00
ar aa. n.N. Sewer -ea. Addis. 100'
25.00
SIM.R.p.n.amWaterN. 30.00
' ater Service 1st 100'
25.00
1 hereby acknowledge that I have read this application, that the Water Service Dra.ain
Addt 20' 30.00
information given is correct, that I am the owner or authorised agent of Storm &Rain Drain 1st 100'
the cwner, that plans submitted are in compliance with State laws, that 25.00
I am registered with the Construction Contractor's Board, that the Storm 8 Rain Drain Addis. 100' _ 25.00
number given is correct. (If exempt from State registration, please Mobile Home Space
give reason below.) Back Flow Prevention
9.00
Device or Anti-Pollution Device
o... Any Trap or Waste Not 9.00
tea••• ••^• '� Connected to a Fixture
9.00
repair 0 Catch Basir _
Describe work new addition U alteration O 40.00Ihr
residential O non-residential O Insp. of Exis. Plumbing
to be done _ 40 OOlhr
Specially Requested Inspections
Rain Drain,
Existing use of single family dwelling
30.00
budding or property Residential backflow prevention 15.00
devices
rn
i- Proposed use of
,..., --- •jFxcept resldentlal backflow
__j building or property prevention devices)
ZZ 11
*Minimum Fee $ 5.00 SUBTOTAL b o
NOTICE --
PERMITS BECOME VOID IF WORK OR CONSTRUCTION 5% SURCHARGE
AUIHORIZEE IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS U
FOR A PERIOD OFF 1180 DAYS AT ANY TIME AF ER 1A TRK ISD PLAN REVIEW 25% OF SUBTOTAL
COMMENCED
TOTAL l
Special Conditions
Date issued by