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14666 SW 106TH AVENUE 1 c/ase." d y � roved• oved• j APP ditiona»y �`p asde_ F.,,f )ed `' N� 'c'ti`� E Co e work as c� X65; F of O T c ..__--...... ' r ,. ....••••• oef p,Jta _,�,4��---►D _ �1�'�� , dress.�?z :, �ate.•,�-�. ,fob 91 r 6 ..�+...........�.�.. .....�.._-�-.....�.a•...-.www..w..�.._-...+-......tif.w++�.......�...�....o....�.�w�.-.+r..•�.. .-... +....._+.�..... ..� -_ _ _—_...._._.,.... "14 ,etetr ��,~.�� fir, - •�"��' -"';?: O L �I :' a imA TE ONIN � N 11CA .r111 � & AIR C O l f D I � 1 0 11 111 G .a -.L 33151; Y 261h Ave Portland, OR 91210 Phone 223.4393 fox 213.44 S-1 � Jet p O% .1_.. .� A... .. . h, 1. .l. i 1V V' • nwJi K X. .k�� .., � � ` �V� n"'yiy�W �N. .. F NOTICE: IF THE PRINT OR TYPE ON ANY T��-j � l � � I � I � { � � I � ' � { � � { � I � � 1 � i � � � { � ; I � � ;- r�t�r� i i �-r`�� -r.Iflfli i � i � � li il � Illf ill ' il � tlili � f ilf ` f 1 ili � fli rlt � t � � fll � fll 11 ( 1111 f 11 ( 111 ► li � ll � IllllCl Ilrllll 1111111 il � l � ► �� G�� IMAGE IS NOT AS CLEAR AS THIS NOTICE, IT IS DUE TO THE QUALITY OF THE No.38 6 Z 11� ,IIII IIII I I I I i(�l11 11 1111 I II III�IIII111 � 1111 .111lIIII1111111II{I II{IIl{{1 {.L{1T h8I lT l 5T bT ET 7t TT T 6 Rit I I Ill 1 L 111 l 11 1111 ��11L1 9 XIlII IIIIZ1I � li II � III11ORIGINAL DOCUMENT 1 ll _111 111. 11i.� III �l1I S ! I 4 I C I i � a 07. 0 2 3 0 0 aIMATE CONTROL .s 11EA [ 11IG & AIR ( 01101f10111Nc -9 3315 NII 161h Ave Porllond, OR 91110 Ph1134393 fox 223.4494 I o one - NOTICE: IF THE PRINT OR TYPE ON ANY Tjrjllt i1i ` � Ii i ! ilili � I � I � 11 i111111 1111111 lit.I� It 111Jill tl ! I ! � � 1111111 1111111 1111111 ! 1111 ► 111 III III Ill 111 III III Ili 111 X11 IIIli1l 1 ! I III Ilf1l1 � III II ► 1111111 I II I I I I I I IMAGE IS NOT AS CLEAR AS THIS NOTICE 1 2 3 11111111 I � 9 - 10 11 12 T IS DUE TO THE QUALITY OF THE No 36 ORIGINAL DOCUMENT E 6Z gZ LZ 8Z Z i►Z 8Z Z TZ 07, 0 t 8 L GI E C tii t T Ot b L e T� Z � � I I I I T .�tli3w� IIII (III IIII 111, 1111 11111 III IIII IlliH I1111Illi �� 1111Ill IIII Illi 1111 III! 1111 IIIIIII. IIII IIII IIIIIIII .1111IIII IIIIIIII IIII IIII ! I IIII 111111 11111 ill! IIII�I11111 IIlli 11 1 1111 � ► � 11 ll 11111 1l L 1 ll I I I I 111 I c u � ' Y x 1 d� a i 1 _ _._.......—_.__.._....._..._....._.._... � Ox f l0, a` ` c) t Lj 1�: (3 .0 aIMATE (ONTROL AA-,t:-Vlt r , --- 11 f A 11 11 6 F AIR ( 0 11 0 1 f 1 0 111 11 6 1� 3315 10261h Ave Poillond. UX 97210 Phone 173.439.1 fox 213.4494 �w.tray NO�iIGE: IF THE PRINT OR TYPE ON ANY Tr 1 ( 1 III III III III III III III III III I-rT -1 ( IT -� J 1..1' _T-1.1 11-T I I I I ! I I I 111 1 1 1 1111 1 1 I j I I ( I ' III 1 1 1 1 1 1-] 1 1 1 111 111 1 I I I I f J l I !1 111 ! 111 III 111 11 11 1 1 11 1 1 1 11111 I., '� � 1 ( I I ! I 1 I I 1 IJilll�� IMAGE IS NOT AS CLEAR AS THIS NOTICE, 1 _ z 3 4 cJ !� _ _ 7 g .._ - lU IT IS DUE TO THE QUALITY OF THE _ No.36 ORIGINAL DOCUMENT 0 1111! 111111Z 11S1116111I81111111111111111111111111111Illllllllillliilii(1111 1111111� 111iiilili111111111111111i11111 .11i111i' 'll! �i'llllilllllllllilllllllllTl.TllllllllTllll11116111IllL t,11�lll ll)Illllllll1ILI[ils llll�lll a O O O cn O O x D m 14666 SW 106'" AVE. CITY OF TIGARD EjILDING INSPECTION DIVISION ST 24 Hour Inspection Line: 639-4575 Busing ss Line: 639-4 1. i -1uP Date Requested_ e; 5/f i AM PM --- ` Bt_D Location Suite _ MEC *� Contact Person nKt Q1�"�-L'� Oh 6� C4Ph 3G-��f� PLM Contractor ..SQS1'ti` '�{��t� deu•4V-L1 Ph 6- 7d-- SWR BUILDING Tenant/Owner ELC Retaimi Wall ELR 'EP91ing- - Access: - ZLndaSior FPS Ftg Drain !-�L�'lt( �, t,Q/ ((n,�,Q � kcyv,,L a,U A4 f — Crawl Drain Inspection Notes: re L,+t ip- /-a4.t_ Ao#-o SGN Slab ! J eve S -WL. /)4-K4 c� C. S(c3.rj SIT Post& Beam C.tPN S - -e i Ext Sheath/Shear Int Sbeath/Shear - — C Framing cy/fl 4 L. Insulation Drywall Nailing _ Firewall —'— Fire Sprinkler r=1= /AT-1 L„ 1! tL_�7ti/e 4 C Fire Alarm Suso'd Ceiling _— Roof Misc: -- i � PART FAIL — BING Post& Bearn ---_----- Under Slab Top Out —�— Water Service _ Sanitary Sewer — — Rain Drains Final ------------------ PASS PART _FAIL MECHANICAL Post g Beam+.fea k.x 4; -- -- - ---- ——__ Rough In l.J r14-1 .4, Gas Line -- Smoke Dampers LAI*. — na PART FAIL ELECTRICAL - - ---- Service Rough In -- UG/Slab Low Voltage - - Fire Alarm Final PASS PART FAIL �— SITE Backfill/Grading - - -— --- - — ---- -- Sanitary Sewer Storm Drain [ ]Reinspection fee of$ _—_required before next inspection Pay at City Hall, 13125 SW Flail Blvd Catch Basin ll f Please call reins ection RE: Fire Supply Line Pl ( ] p ( ] Unable to inspect - no access ADA ApprOther oach/Sidewalk Date ��-� lS!/� - Inspector r Ext Final --- PA38 PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 -- BLIP Date Requested /ail 5 AM PM _ BLD Location t'44( � 564� I Ut4z �-- -- Suite _ MEC Contact Person zhr1 �.I�aS 2r Ph 031 65Y3 PLM Contractor �5 � C �/l'�YU ( Ph S 7� `(�4 41 _ SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation rlc_ L�. ,, r 11,/L�(.� �c �l.-GYL(.R (iu- S Ftg Drain .._.__----- ---- Crawl Drain Inspection Notes: SGN Slab _�_�._ - — ------ - --- -- SIT Post& Beam - Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler - Fire Alarm Susp'd Ceiling MOS f Final PASS PART FAIL --- -- PLUMBING Post&Beam — Under Slab Top Out ---- Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL _MECHANICAL Post&Beam -- — — Rough In Gas Line - - Smoke Dampers 71 Final - - - - - - _ --- .-PASS PART PART FAII. i ELECTRICAL Service Rough In - ---- UG/Slab _ Low Voltage r rrn P-ASI PART FAIL. _ Backfill/Grading - - - - - - Sanitary Sewer Storm Drain [ J Reinspection fee of$ required before n inspection ay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( )Please call for reinspection RE: _ ( J Unable to inspect-no access ADA Approach/Sidewalk Other Date `5--- Inspector U Ext Final PASS PART FAIL I DO NOT REMOVE this inspection record from the j b site. _ ELECTRICAL PERMIT CITY OF TIGArRD PERMIT#: ELC1999-00721 DAiE ISSUED: 12/03/1999 DEVELOPMENT SERVICES 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 4171 PARCEL: 2S110A1) 01900 SITE ADDRESS: 14666 SW 106TH AVE ZONING: R-12 SUBDIVISION: LANG HILL LUT : 016 JURISDICTION: TIG BLOCK: Proiect Description: Electrical alteration —_ TEMP SRVCIFEEDERS — MISCELLANEOUS RESIDENTIAL UNIT — — PUMP/IRRIGATION: 1000 SF OR LESS: 0 200 amp: 201 - 400 amp: SIGN/OUT LINE LTG: [E--ACH 'LADD500SF: 401 600 amp: SIGNAL/PANEL: LIMITED ENERGY: MINOR LABEL (10): MANE HM/ SVC/ FDR: 601+amps 1000 volts: SERVICE/FEEDER _ BRANCH CIRCUITS ADD'L INSPECTIONS WISERVICE OP FEEDER: PER INSPECTION: 0 - 20C amp: PER HOUR: 201 - 400 amp: 1st WIC Sr�dC OR FDR: � IN PLANT: 401 - 600 amp: EA AUD'L BRNCH CIRC: 1 _PLA_ N REVIEW SECTION 601 - 1000 amp: _ >=4 RES UNITS: > 600 VOLT NOMINAL: 1000+ amp volt: CLASS AREA/SPEC OCC: Reconnect only: SVC/FDR >= 225 AMPS: Contractor: Owner: BOONES FERRY ELECTRICAL HAASE, JOHN G PO BOX 628 14666 SW 106TH AVE WILSONVILLE, OR 97070 TIGARD, OR 97224 Phone: Phone: 682-4936 Reg #: SUP 3170S LIC 000BB482 ELE 3-223C FEES Required Inspections __—_— Type By Date Amount Receipt Elect'I Service PRM BI ON 12/03/1995 $42.85 99-320147 Elect'I Final 5PCT BON 12/03/199E $3.43 99-320147 Total $46.28 ORIGINAL This permit is done subject to the nce wregulations h lapp approved plans, This permit rd ill expire if work is unicipal Code,State ot starrtR Specialty td within 180 ddayssand of ssull other ance.or I wlcable ork is laws All work will be done in accordance days. PP suspended for mom then 95 001-0010 throughON, Oregon law requires you to follow OAR 952-001-0080, you may obtainucop es adopted by the rulesOregon o d�ectllity Notif questions toon OUNCtat(503)se rules are set forth in OAR 952 246-1987. pFRMITTEE'S SIGNATURE ISSUED BY: OWNER INSTALLADT" ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: _ DATE: CONTRACTAOR INSTALLATION ONLY ——--------- ----- !L , `l, _ DATE: SIGNATURE OF SUPR. ELEC'N: -- LICENSE NO: Call 639-4175 by 7:00pm for an inspection the next business day CITY OF TIGARD Electrical Permit Application Pt an Check 13125 SW HALL. BLVD. Recd By ��'�_ TIGARDD OR 97223 Date Recd �! — Phone(503)639-1171, x304 Date to P.E. _ E,ale to DST -C Inspection(503)639.4175 Print 'nt of Type Pemnd e L ' ,-; l� Fax(503)598-1960 Incomplete or illegible will not be accepted Called— 1. Job Address: 4. Complete Fee Schedule Below: Name of Development _ Number of Inspections per permd allowed Name(or name s&oft business) ,�h k3 q 4L5 ce _ Service included: Items Cost Sum—T Address eZ' (v ._�'2 /rlr/9_'4ye 4a. Residential-per unit -- City/stale2ip T r�, 1 ��✓� j 'f 1000 sq ft or less - - S 1 t 7 7.5 J_ 4 - — tach additional.500 sq ft or portion thereof S 2G 2S t Commercial❑ Residential� Limned Fnergy _ $ so 00 - F"adi rdanc?d liomc or MWular 2a. Contractor installation only. Dwelling;.;ervice or I eerier S 72 15 _ 1 (Prior to permit issuance,appbcmrrt%must provide contractor license 4b.Services or Feeders infonttaborl for COT data base). Installation,alteration,or relocation FlecUical Contractor F300 N E?S FERRY E;L _�� zoo amps or MSs S 6425 2 Address P 0 Box 6 2 8 201 am601 amps to 110(x)ps to 400 amps --- --- S 8550 - -__ 7 City_W l s o n;.-,-11-1 Slate O R Zip 9 7 0 7 0 - - 401 amps to 00 amps `- s 12850 - --- amPsf 199.50 Phone No 503-682-4936 —_ Over 1000 amps or volls $ 363 75 - Job No _ Reconnect only - - $ 5350 - Flec.Cont Lice. No3-223 C Exp Dalp 1 31 0 0 4c.Temporary Services or Feeders OR State CCB Reg No. 8 8 4 8 2 FXp.Date 2/2 3/01 Installation,alierafion,or relocation COT Business Tax or M400 No. 0 2 8 5 JA Exp Date 8 1 9 200 amps or less _ $ 5350 201 amps to 400 amps S 8025 Signature:of Supr BI'ec n !_uL�L� 401 amps lu 600 amps _ — S 1707 00 Over ri00 amps to 1000 volts. License NO 3 1 70 sae"b"above Phone No 6 82-- 3 6 Ftp" le 10 1/O 1 4d Branch Clmufts - —- Now,afteration or extension per panel a)The fee for branch circuits 2b. For owner installations: wfth purchase of service or feeder roe. Print Owner's NafTlr _ Each branch circuit S 5 35 _ 2 Address b)The fee for branch dicuits �;"--�- -- without purchase of servrro (,fly- , - ,Mate —Zip— -- or feeder fee. Phone No --- -. -- -- -- I irst branch circuit _ $ 37.50 Each additionalhranch circuit _ L _ f 535 The instailation is being made on property I own which is not 4e Miscellaneous intended for sale,lease or lent (Service or feeder not rnduded) Each pump or litigation circle S 42 75 Owner's Signature_ _ Each sign or outline lighting S 42 75 Signal circuit(s)or a limited energy panel,alleration or extension S. 13000 3. Plan Review section (if requirrrd): Mmol I attels(10) —_ S 107 00 Please check appropriate Item and enter fee In section 5173 4f.Each additional inspection river _4 or more residential unils in one structure the alkilvable fn any of the above Servkn and feeder 225 a Per Inspection S 50.00 rips or mare - - System over 600 vults rimninal Per hour S 50.00In Plant ---� 5900 "-- S Classified ntea or slnrqurr.containing special oc�uhfinc:y a; - --"'-'—'" described in N E C Chapter S 5. Fees: Sa Enter total o1 above fees Submit 2 set%of plans with appficalinn whom any of the above apply $A Surcharge(05 X lntai fees) S �ar_ Not required for temporary construction services Sub(cital s Sb.Friter 25%of line Sa for NU11Ct Ran Review if required(Sec.3j S I"FRMITS tlECOME VOID IF WORK OR CONSTRUCTION AU IHORIZF_D Subtotal S IS NOT COMMENcrD WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Acccuor u AT ANY TIME AFTER WURK IS COMMENCED Total balance Dlte $ '141 � Ads lformsklectris doc \ CITY OF TIGARD _BUILnINGPERMIT PERMIT#: BUP1999-00485 DEVELOPMENT SERVICES DATE ISSUED: 11/19/1999 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S110AD-01900 SITE ADDRESS: 14666 SW 106TH AVE SUBDIVISION: LANG HILL ZONING: R-12 BLOCK: LOT: 0.6 JURISDICTION: TIG REISSUE: _ FLOOR AREAS _ EXTERIORWALL CONSTRUCTION CLASS OF WORK: ADD FIRST_ 6 sf N: S_ E: W: TYPE OF USE: MF SECOND: sf _ PROJECT OPENINGS? TYPE OF CONST: 5N sf N: S: E: W: OCCUPANCY GRP: R3 TOTAL AREA: sf ROOF CONST: FIRE RET? OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED: STOR: 1 HT: 8 ft GARAGE: sf OCCU SEP. RATED: BSMT?: MEZZ?: REQD SETBACKS REQUIRED FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET: DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : F-INDICP ACC: BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING: VALUE: $ 6,630.00 Remarks: Construction of a 6 square foot mechanical closet to an existing multi-family dwelling. Owner: Contractor: I IAASE, JOHN G CLIMATE CONTROL HTG + A-C 14666 SW 106TH AVE 16500 SW 72ND AVE I IGARD, OR 97224 TIGARD, OR 972.24 Phone: Phone: 453-4822 Reg #: LIC 00062196 PLM 26-536 FEES REQUIRED INSPECTIONS Type By _ Date Amount Receipt Footing Insp 1 �PLCK DEB 11/17/199E $62.56 99-319811 Foundation Insp Framing Insp I-IRE DEB 11/17/199 $38.50 99-319811 Final Inspection PRMT BON 11/19/199f $96.25 99-319896 ORIGINA1 .1 5PCT BON 11/19/199E $7.70 99-319896 (additional fees not listed here) Total $245.01 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance ,vith 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 the t ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -0010 through OAR 952-001-1987 You may obtain a copy of these rules or ifert questions to OUNC by calling (503) 2.46-1987. Pe rm itee Signature: Issued By: Call 639-4175 by 7 p.m. for an inspection the next business day CITY OF,TIGARD Multi-Family Buildin,.; Permit Application Plan Check# :13125 SW HALL BLVD. New Construction and Additions Date Recd TIGARD, OR 97223 Date to P.E. (503) 639-4171 Date to DST // Permit 0 -Go'�i3s Print or Type Called Incomplete or illegible applications will not be accepted r 15 Ar' r;^ Narne of DevelopmenUProject Existing Building gNew Building Job Address Site Address Building Number of Units I�466 /06-M itiData Bldg# City/State Zip — Existing Use of Building or Property: ---- -- / . �7-22 ,lame Com'' n Property A Sq. Ft. of Dwelling: Sq. Ft of Garage. Owner Mailing Address Suite /yo� 1 - i �W n` .'t Proposed Use of Building or Property: City/State ZIP Phone -1'722 t/ .S 1 C,:/ Name / J / No Of Stories: General Contractor Mailing Address Suite -- Ocrupancy Class(es) Prior to permit -0ty/Slate ZIP Phone Type(s) of Construction Issuance,a copy 1 of all licenses n A Const, .Board % , Will this project have a Fire Suppression System? are required If Oregon Const.Cont.Board Lic# Exp.Date expired In C,O.L /O-025--ei Yes [f No E] database �� / ? /0 - OD Americans with Disabilities Act (ADA) -� — Narne - Valuation X 25% = $ Participation Complete Accessibility Form Architect Project $ Mailing Address Suite Valuation 30 City/State Zip - Phone Plans Required: See Matrix for numbe of sets to submit on back / Engineer Name fr- l C�^i I hereby acknowledge that 1 have read this application,that the information Mailing Address Suite given is correct,that I em the owner or authorized agent of the owner,and that plans submitted are in compliance with Oregon State Laws Clty/State Zip Phone Signature of Ow ger/Agent Date Indicate type of work: New O Addition 0 Demolition O Contact Person Name Phone Accessory Structure O Foundation Only O Alteration O rryt r1 tA h 18 Repair O Other O 1 Description of work: FOR OFFICE USE ONLY A�1 ? / Plat# Map/T N:: tCl ^e('44mer�tl C)Vslef 1,16-, —D/�OtS Zoite I Engineering Approval TIF Planning Approval. Note: Site Work Permit Application must precede or accompany Building Permit Application tIP' i ldstslformslmultinew doc 10/28/gi6 MULTI-FAMILY PLAN SUBMITTAL REQUIREMENT MATRIX ,An Review is dependent upon submittal of BOTH plans AND a COMPLETED :application. For an electrical submittal, the application must contain the signature of the supervising electrician before plan review will be conducted. After plan review approval, Plans Examiner will contact the applicant to request additional plan sets for distribution purposes. (Copy for Contractor, City, Washington County, Tualatin Valley Fire & Rescue) Tota! # of TYPE OF SUBMITTAL Plans KEY: Submitted S (Private) S = Site Work B (New or Add) i B = Building F (New or Add or Alt) 3 F = Fire Protection System M (New or Add or Alt) 1 M = Mechanical B & M (New or Add) 1 P = Plumbing P (New, Add, or Alt) 2 E = Electrical B & M & P (New or Add) 2 New = New Building E (Nsw, Add, or Alt) 2 Add = Addition B & F 8 M & P � 3 Alt = Alternation to Existing (New , Add) — _ __ _ Building kB or B & M (Alt) T *B & M 8 P (Alt) � 3 •B � M 8 P & E(�11t) y��3 3 NOTES: 'Shaded areas designate ALT submittals only I\fists\•natrxmltdoc 08/18198 CITYOF T I GA IR D MECHANICAL PERMIT DEVELOPMENT SERVIC;ES PERMIT#: MEC1999-00492 13125 SW Hall Blvd., Tigard, OR 97223 (503) (339-4171 DATE ISSUED: 11/19/1999 SITE ADDRESS: 14666 SW 106TH AVE PARCEL: 2S 110AD-01900 SUBDIVISION: LANG HILL ZONING: R-12 BLOCK: LOT: 016 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN- FVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: LINK VENTS W/O APPL: VENT SYSTEMS: STORIES: _ BOILERS/COMPRESSORS HOODS: _ FUEL TYPES 0 - 3 HP: DOMEzi. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 -30 HP: FIRE DAMPERS?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + Hp: WOODSTOVES: FURN < 100K BTU: 1 _ AIR HANDLING UNITS CLO DRYERS: FURN —100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS Remarks: Relocation of gas furnace to new mechanical closet. Owner: — _ FEES HAASE, JOHN G Type By Date Amount Receipt 14666 SW 106TFI AVE — TIGARD, OR 97224 PRMT BON 11/19/195 $50.00 99-319896 PLCK BON 11/19/195 $12.50 99-319896 5PCT BON 11/19/195 $4.00 99-319896 Phone: --- Contractor: --- Total —$66.50 -- CLIMATE CONTROL INC 3315 NW 26TH AVE PORTLAND, OR 97210 REQUIRED INSPECTIONS Gas Line Insp Phone:223-4393 Heating Unt Insp Reg#:LIC 62196 Duct Inspection Final Inspection ORIGINAL- 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 foliow rules adopted n the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-'1080. You may obtain copies of these rules or direct questions to OUNC by calling (503)241-0189. Issue B \' Y� �1v' ' '�-�� (t.'� �_ Permittee Signature: Call (503) 639-4175 by 7:00 P.M. for inspections needed the next busiriess day Plar Check# 'S� CITY OF TIGARD Mechanical Permit Application Recd By 13125 SW HALL BLVD. Commercial and Residential DateRec'd !/-lb-49 TIGARD, OR 97223 Date to P.E. (503) 639-4171, x304 Date to DST Print or Type Permit#�£C,/7 v �a _ IncoCalled i'_mplete or illegible applications will not be accepted _Name of Developmenl/Proled Description Table 1A Mechanical Code Qt Prig: Amt �ess Surte# -- A) Peimit Fee _ 16.00 Job Street Add -- —" Address �� <W loft 1) Furnace to 0 BSU including ducts cls&8 vents _ see footnote 1,2 ! 965 � •- Bldg# CdyrState`` Zip 2) Furnace 100,000 BTU+ i nrls_ JlJ l� _I including ducts&vents _see footnote 1,2 12.00 Name for name of business) 3) Floor Furnace Owner Oh n N Aja. it vent see footnote 1,2 9.65 4) Suspended heater,wall heater Mailing Address or floor mounted heater see footnote 1,2 9.65 I D� Ls 5) Vent not included in appliance permit 4.75 Cny/StWe Zip Phone Check all that apply 'Boiler Heat Air e4 �]]11 ,• For items 6-10,see or Purnp Cond Qty Price Amt Name Tor name of business) footnotes 1,2 Comp 6)<311P,absorb unit to F 100K BTU 9.65 Occupant Mailing Address 7)3-15 HP,absorb unit 100k to 500k BTU — _ 17.65 City/Slate Lp Phone 8) 15-30 HP,absorb unit.5-1 mil BTU _ 24.15 9)30-50 HP,absorb 36.00 Contractor Name 1 unit 1.1.75 mil BTU C / �^4�� 01 10))>50HP;absorb unit -- -- -_ Prior to permit Mailing Address / >1.75 mil BTU 60.15 Issuance,a copy ' / �� ff v<' 11 Air handling unit to 10,000 CFM of all licenses crly!Stale 1 Zip Phone7.00 are required if _ I -'I nr r l.'/r `/!� _ 12)Air handling unit 10,000 CFM+ expired in COT Oregon Const.Cont Board Llc# Exp Date 11.85 database_ 13)Non-portable evaporate cooler 7.00 Architect Nrme _ 14)Vent tan connected to a single duct 4.75 or Mailing Address 15)Ventilation system not Included in appliance permit 700 Engineer CRY/State zip Phone 16)Hood served by mechanical exhaust 7.00 Describe work to be done 17)Domestic incinerators 12.00 New O Repair O Replace with like kind. Yes It No O 16)Commercial or industrial type incinerator 48.25 Residential Commercial _ 19)Repair units -- 8.40 Additional information or description of work' I j � 20)Wood stove/gas FP/other units/clothe dryer/etc. I,- n 7,00 NOTE: For Commercial projects only,Units over 400 lbs require 21)Gas piping one to four outlets structural gas talcs. See footnote 1 3 75 _ Type of fuel oil O natural gas 0 LPG O electric O 22)More than 4-per outlet(each) 75 Minimum Permit Fee$50.00 SUBTOTAL _ I hereby acknowledge that i have read this application,that the Information 8%SURCHARGE given is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL the owner,that plans submitted are In compliance with Oregon State laws Required for ALL commercial permits o9A TOTAL Signatory of Owner/Agent �� Date -- - --- --- Other Inspections and Fees: J 1. Inspections outside of normal business hours(rnininum charge-two Contac!Penson Name Phone hours) $50.00 per hour 2 Inspections for which no fee Is specifically Indicated (minimum charge-half hour) $50 00 per hour _ 3. AdditiL nal plan review required by changes,additions or revisions to Foonotes for commercial projects only: plans(minimum charge-ono-half hour)E50.00 per hour 1 Provide full schematic of existing and proposed gas line and pressure 2. Provide drawings to scale showing existing and proposed mechanical 'Stale Contractor Boiler Certification required units. — - --- "Residential A/C requires site plan showing placement of unit I Vnechperm doc rev 7119/99 06 > f . FP 4V Ze ow?0 V e 01c I r /1 ok rr I e4'^ VCW%('� 0 lApA, S6 06(1 bill,/4 )1 PK ex4a*�rll; I It o y a IMA TE CON TR OL /I E A f / It G & AIR ( 0 110 1 f / 0 11111 G 01N 331S 11IV261h Ave Poillond, OR 97210 Phone 223-4393 fox 2234494 P/61 ki ( ( 7lITII 11 1 1111 NOTICE: IF THE PRINT OR TYPE ON ANY 1` 1 11111 [ fil I 1-i- I I 1 1 1 1 1 1 1 1 1 1 , _ _ 4 _ _ _ ___6 ____ ___ '7 . 8 IMAGE IS NOT AS CLEAR AS THIS NOTICE 10 ITIS DUE TO THE QUALITY OF THE No.36 6 1 0 11111 9 1 11 I z 0 1111111 ORIGINAL DOCUMENT 11111111111l.l.l 111{ lllllllll ll1111,_! IIID 111 it,1 1111 ILI Z11 11' 1119, 111 1111119, 11 11 J�11 7HII I I t1l I 11 T11 1 111111 1111111111 11