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11658 SW 113"' Place
CITYOF T I G A R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002-00534
13125 SW Hall Blvd.. Tigard, OR 97223 (50::) 639-4171 DATE ISSUED: 11/27/02
PARCEL: 1 S134DC-04901
SITE ADDRESS: 11658 SW 1 13TH PL
SUBDIVISION: MUTTLEYS ADD!TION ZONING: R-4.5
BLOCK: LOT: 026 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP. VENTS W/O APPL: VENT SYSTEMS:
STORIES: B_OILERSiC_OMPRESSORS HOODS:
_ FUEL TYPES 0 3 HP: DOMES. INCIN:
LPG1 3 - 15 HP: COMML. INCIN:
MAX INPU r: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODS T OYES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: _ AIR HANDLING UNITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm- - GAS OUTLETS: 1
> 10000 cfm:
Remarks: Gas Insert
Owner: — ^ i FEES--.---
KLUDAS, DONALD C + JEAN C Description Date Amount
11658 SW 113TH PL -- ---
TIGARD, OR 97223 j 11 I'rrmit Fcr 11/27/02 $72.50
I,MIA III I'wnut Ice 11/27/02 $0.00
I A X I ,ti".,~tate I ax 11/27/02 $5.80
Phone: 502-X92-.1687 I'rn,x I State]ax 11/27/02 $0.00
Contractor: Total $78.30
LUDEMAN'S FIREPLACE + PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005-2129 REQUIRED INSPECTIONS
Phone: h4(,-c,-1uO Gas Line Insp
Reg #: 5140)
This permit is issued subject to the regulations contained in the Tigard MUni6pal 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 rr,.-re 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 9B2-001-0010 through OAR
952-001-01 )0. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699
Issued by: � __ Permittee Signature:
Call (503) 639-4175 by 7:)0 P.M. for inspections needed the ne9t business day
06. 22 :001 14:43 FAX 303884729T Citr of Tigard 10002
Mechanical Permit Application
Daltrtxtived. 7Perrsutn4 � ' ?'7i .UG Ci of T��'ppard -A�W�L `b Pro)e:t/appl.no.:;y of 71#ani Address: 1312.3 Sw Hall Blvd,Tigard,OR 97223Phone: (503)639-4171Dstctssucd: ptno.:
Fax: (503)598-1%0 Cast file no.. IPaymentrype.
Land use approval: __—
building pernut no..
❑ I &2 fArrWy dwelling or at ccssury ❑Cotnrrfuc:iavindusuial J Stulti-fanuly J Tcnau(intptuvcrtacnt
O New eontttuction O Addition/attetatiordreplacement G(niter
M 110 11 a 11,11111](10111M Ito MTMITTM
Job address: .9- '-', ( � �- _ Indicate:(Iu)pmcni cluantiucs to boxes below Indicate the duUsr
BId .no.! State no. value of all mechanical materials,equipment,labor.uvcniead.
Tax maphax lot/account no.: — - profit.Value S
Lot Block: Subdivision: i- 'See checklist for important application information and
Proem name: f{ N jurisdicxion's fee schedule for residential permit fee.
Ci /county: j-;� , ZIP: <- '�7 -f ar
ill
Deseripttaa and l0 00 of work oo I remises:
F'tx(tat.) Total
ESL dateofcompietionfins "on: 1 Res.only Res.otd
Tenant improvement or change of use: AC
Is existing space heated or conditioned?O Yes O No Air handling amt CFM
ate
Ale t:ond)tlr Ila (stirtali trtd) _
Is existing apace msf+lated?O Yes O No -
A tetattnn fez A hyttem
M a/corq esson
State boiler permit no.
Business crane r _— HP —_Ttms BTU/H
Addn_css.L,�G7 r trusMoke d.mpers/dtrct stoke ttetactors
CityU State:p ZIP O ea urop(afu p a1 e n qurred►
Phone- & F E-Itlail: nrul Nv ner 'H-I`ITA/
Including ductrorkh�em liner U Yes O No
CCFi no.: _S /(4 p ' e7P3 P7-- ---- —_e---_ insu . rrocate ennuis.-suspended,
Qtylmatro tic.no.. _ wall.or floor mounted
Name(please pnnt): 4 + crit 4P -other .n hurter
��tloer
Absorption units HTU/ti
Clutters ._ -- — lip
,m
Addtsss: - t� 'FAVireamse ..Rl�sr
City _ Is ZIP- Appliencovent
Phone: Far E-matt: er -
Hoo" I ypc rca. asmat
/ bond tin suppression system
C`i.l , / Rahaett fan with single duct th tans)
Malin audrest: auu - or
City; . G' State • ZIP: y� QPM� sup to 4 outlets)
Fill: E maul: el pip each oe over outicts
taeertpitatxisc cm-ucrtq%n t
Number of outlets
Add t— --.--. -- _— ---- ids mer pews:
__ _ Daorauref tote
C _ _-_—_ Stott: _ ZIP:
one: F'ax ^mail. � w"�Pet�f►ow— ----
Applicant's si nature:t.— Date: Odw --
Name riot) /
Na a0 tirtatc>ta.rca-uuif�..h.�r�r�!I*"#Woew for woe e/ennsaa Permit tee.....................S
O vias a Mycid ntpites if a permit it tart� Nona:This permit nixpplobbtotaainned Minimum fee................f
um —
Cndif d .wf_
� —1_1� Plan review(at ..._ '4+1 S
more. within 110 days atter it hu been _-
—-Tier aTw,7i.tT. w (
s Sta
— — amepted of m plete ge lrChuEe 896)....SUFO -
_ s TOTAL...........- .....S
t' dea.rtaa _—_ —_ A�a.ai .w.en tltoatDOM
MEN
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
MST
INSPECTION DIVISION Business Line: (503)639-4171
BUP .—
Received —_—_--I—Date Requested2- , _ AM____ PM BUP
Location —[ �_ �- �` Suite_ MEC
Contact Person Ph( ) °-"� n PLM —_
Contractor —__ __ Ph( ) c1 SWR
BUILDING Tenant/Owner
Footing '`f✓ _
Foundation Access:
Ftg Drain ELR --__
Crawl Drain
Slab Inspection Notes: J SIT
Post 4 Beam
Shear Anchors ` lk
Ext Sheath/Shear
Int Sheath/Shoar
Framing-- SEAL A ��✓���� �%� 1��� G�✓i � i l� �._.—.
Insulation
Drywall Nailing —- --— —
Firewall
Fire Sprinkler -- --- --
Fire Alarm
Susp'd Ceiling
Roof
Other: ---
Final
PASS PART FAIL --
PLUMBING
Post&Beam
Under Slab -----.._ .----- --- -- --
Rough-In
Water Service -
Sanitary Sewer
Rain Drains - -----
Catch Basin/Manhole
Storm Drain --
Shower Pan
Other: —` ---- _
Final -----------__
M19=4ML FAIL ----- ____----- - ---'-MECHANICAL,)
Pos e r _ --------
Rough-In -- ---- - -- -------- - ---- -
Gas Line
Smoke Dampers
APART FAIL ------ --- -- ---- - ------
ELECT_RICAL
Service --
Rough-In --- ------ --------- — —
UG/Slab
Low Voltage --
Fire Alarm
Final l J Reinspection fee of$__ required before next inspection. Pay at City Hell, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Y_ C] Please call for reinspection RE: _—. [_—_— [J Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sldewalk tib !S i u `� Inspector _ _ _.—_Ext -
Other: -
Final - DO NOT REMOVE this Inspection r000rd from the job site.
PASS PART FAIL