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12972 SW 113"' Place
CITYOF TIGARD MASTER PERMIT —
DEVELOPMENT SERVICES DATE ES UIED: MS9/20001-00004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171
SITE ADDRESS: 12972 SW 113TH PL PARCEL: 2S103AC-07400
SUBDIVISION: FONNER WOODS ZONING: R-4.5
BLOCK: LOT:010 JURISDICTION: TIG
REMARKS: S/F Path 1
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK. NEW HEIGHT: 23 FIRST: 1,148 of BASEMENT: of LEFT: 5 SMOKE DETECTORS: Y
TYPI°OF USE: SF FLOOR LOAD: 40 SECOND: 1,444 of GARAGE: 586 of FRONT: 20 PARKING SPACES: 2
TYPE OF CONST: 5N DWELLING UNITS: I FINBSMENT. of RIGHT: 24
OCCUPANCY GRP: R3 BOOM: 4 BATH: '71 TOTAL 2.592 00 of VALUE: S 236,992 00
REAR: 15
PLUMBING
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: 100 TRAPS:
LAVATORIES: 4 DISHWASHERS: I FLOOR DRAINS: SEWER LINES: 100 SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS 1 WATER LINES: 100 BCKFLW PREVNTF I GREASE TRAPS:
MECHANICAL OTHER FIXTURES:
FUEL TYPES FURN<'10OK: 1301UCMP c 3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN>000K: 1 UNIT HEATERS: HOODS: 1 OTHER UNITS: t
MAX INP: btu FLOOR FURNANCES: VENTS: t WOODSTOVES: G%S OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVCIFEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 0 200 amp: 0 •200 amp: WISVC OR FDR: 1 PUMPIIRRIOATION: PER INSPECTION:
EA ADD'L 500SF: 5 201 •400 amp: 201 •400 amp: let WIO SVC/FDR: 00 SIGN/OUr LIN LT: PER HOUR:
L JITED ENERGY: 401 •600 amp: 401 600 amp: EA ADDL 8R CIR: SIGNAUPANEL: IN PLANT:
MANU HM/SVC/FDR: 601 • 1000 AMP: 601+ampe•1000v: MINOR LABEL:
10004 ampIvolt:
Reconnect only:
PLAN REVIEW SECTION
>wl RES UNITS: SVCIFDR>•225 A,: >600 V NOMINAL: CLS AREAISPC OCC:
ELECTRICAL•RESTRICTED ENERGY
A.SF RESIOF.NTIAL 8 COMMERCIAL
AUDIO&STEREOVACUUM SYSTEM • AUDIO 6 STEREO FIRE ALARM: INTERCOMIPAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: x OTH BOILER: HVAC LANDSCAPEARRIG: PROTECTIVE SIGNL:
GARAGE OPENER: x CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC x DATA/TELE COMM: NURSE CALLS: TOTAL N SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 7,019.96
K&W DEVELOPMENT INC K 8 W DEVELOPMENT INC This pe „.lit is subject to the regulations contained in the
9155 SW RAMBLER t.ANE 9151,SW RAMBLER LN Tiga d Municipal Code,State of OR. Specialty Codes and
PORTLAND,OR 97223 PORTLAND,OR 97223 all other applk:able laws. All work will be done In
asoordance with approved plans. This permit will expire If
work is not started within 180 days of issuance,or if the
work is suspended for more then 180 days ATTENTION
Phone Phone: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center Those rules are set
Reg a' LIC IIn"n forth in OAR 952-001-0010 through 952.001-0080 You
may obtain copies of these rules or direct questions to
OUNC by calling(5031 246-1987.
�3-8 to-g'� REQUIRED INSPECTIONS
Erosion Control Insp 8, Post/Beam Mechanical Mechanical Insp Shear Wall Insp Insulation Insp Mechanical Final
Sewer Inspection Underfloor insulation Plumb Top Out Exterior Sheathing Inst Rain draln Insp Plumb Final
Fooling Insp Footing/Foundation Dr; Electrical Service Low Voltage Water Line Insp Final inspection
Foundation Insp PLM/Underfloor Electrical Rough In Gas Line Insp ApprlSdwlk Insp Building Final
POSUBga"tSRUctural Mechanical Insp Framing Insp Gas Fireplace Electrical Final
Issu By : �Y4 Permittee Signature _� t
Call (50W6194175 by 7:00 p.m. for an Inspection needed the next business day
CITY OF T1GARD
FONNEA WOODS
LOT 10
(7.506 S0. Ft)
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CITY OF TIGARD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
3 MOUNTAINS PLUMBING
PO BOX 386
SHERWOOD, OR 97140
Plumbing Signature Form
P^r-,,;` It: r1ficT2nn1 nnnnn
Date Issued: 1119!01
Parcel: 2S103AC-07400
Site Address: 12972 SW 113TH PL
Subdivision: FONNER WOODS
Blocl, Lot: 010
Jurisdiction. TIG
Zoning: R-4.5
Remarks: SIF Path 1
Your company has been indicated as the plumbing contractor for the permit indicated above. In order far the
plumbing permit to be valid, please have the appropriate individual from your c(,nipany sign below and return
this Plumbing Signature Form prior to the start of the work to the address above, ATTN Building Dept.
No plumbing inspections will be authorized WItil this completed form is received
OWNER PLUMBING CONTRACTOR,:
K & W DEVELOPMENT !NC 3 fOOUNTAINS PLUMBING
9155 SW RAMBLER LANE Pn B,)), 186
FORTLANO, OR 912,23 SHER4'GOD, OR 9714G
Phone #: Phone #: 503-925-1342
Reg #: I Ir 141187
PI M 34-368PB
AN INK SIGNATURE IS REQUIRED ON THIS FORM
--_ -
X ,, ,.__
Signature of Authorized Plumber i-to- a j
If you have any questions, please call (503) 639-4171, ext. # 310
CITI' OF TlrnRD
13125 S.W. HALL BLVD.
TIGARD, OR 97223
IMPORTANT PERMIT NOTICE
TEAM ELECTRIC CO
9400 SE CLACKAMAS RD pp
CLACKAMAS, OR 97015 � IECEIVED
Electrical Signabire Form f4# 11 10U1
Permit #: MST2001-00004 �� �CrRIC
Bate Issued: 1119/01
Parcel: 2S103AC-07400
Site Address: 12972 SW 113TH PL
Suhdivision: FONNER WOODS
Block: Lot. 010
Jurisdiction: TIG
Zoning: R-4.5
Remarks: SIF Path 1
Your company has been indicated as the electrical contractor for the permit indicated above. In order for the
electrical permit to be valid, the signature of the supervising electrician is required. Please have the
appropriate individual from your company sign below and return this Electrical Signature Form prior to the
start of the work to the address above, ATTN Building Dept.
No electrical inspections will be authorized until this completed form is received
OWNLR ELECTRICAL CONTRACTOR-.
K & 1111 DEVELOPMENT INC TEAM ELECTRIC CO
9155 SW RAMBLER LANE 9400 SE CLACKAMAS RD
PORTI AND, OR 97223 CLACKAMAS, OR 97015
Phone #: Phone #. 557-7 1 80
Req #: uc 004731
SUP 1819S
ELE J-2250
AN INK SIGNATURE IS REQUIRED ON THIS FOR
�-
Signature of Supervising Electrician
If you have any questions, please call (503) 639-4171, ext. # 310
CITY OF TIGARD BUIILDINC INSPECTION DIVISION 7� MST
24-Hour Insuection Line: 62 '75 r`usiness Line: 639-4
/ B U P
C.to Requested_ l - 4AM PM _ BLD
Location ! - 1' 7Z l -73 F2-' Suite MEC
1 � Ph .�� � �mss! PLM
Contact Person
Contractor
Ph SWR
ELC --------_.._- __-__
BUILDING Tenant/Owner
EL.R
Retaining Wall
Footing rInspection
cess: FF'S
Foundation
Fig Drain - SCAN ---- _
Crawl Drain Notes: - SIT
Slab —_- ---- --.
Post& Beam
Ext She0h/Shear
Int SheathlShear � — Ie re
Framing
Insulation
Drywall Nailing -
Firewall
Fire Sprinklor - --
Fire Alarm —_
Susp'd Ceiling -
- --- --------
Roof
Misc:
T
PASS PART FAIL - -
nUfMING --
Post& BLani
Under Slab
Top Out
Water Service -
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL —_ —
Post & Eeam - -
--
Rough In -- -- ----
Gas Line - — -
Smoke Dampersin -i
S .� PART FAIL. — --
EL CRICAL --
Service -- - -- --
Rough In
UG/Slab - -- --
l_ow Voltage _
Fire Alarm -
Final
PASS PART FAIL -SITE
Backfill/Grading v
Sanitary Sewer required before next inspection Pay at City Hall, 1:125 SW Hall Blvd
Storm Drain [ J Reinspection fee of$
Catch Basin [ ]Please call for reinspection RE: [ ]Unable to Inspect-no access
Fire Supply Line /
ADA (.��til
Approach/Sidewalk Date 7 Inspector Ext _
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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CITY OF TIGARD BUiLDiNG INSPECTION DIVISION MST ZCC)l
24-Hour Inspection Line: 63. 175 Business line: 639-4
BLIP --
Date Requested_ —AM PM BLD
Location `� Z 72, � �� Suite MEC _r
Contact Person 0 e 'u-- Ph �2e cZ PLM
Contractor Ph SWR �—
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: r kY FPS
Foundation , �i/�7�7"� Com?T/��f /' �
Ftg Drain ' c SGN
Crawl Drain Inspection Notes: ---
Slab __ - SIT
Post R Beam
Ext Sheath/Shear
Int Sheath/Shear \
Framing 'rase->'-y_Crnc 5
Insulation
Drywall Nailing — --�Z''
-
Firewall
Fire Sprinkler
Fire Alarm (�
Susp'd Ceiling
Roof V;!,
S w
Misc:
Final ��
PASS PART FAIL �' c yin j—,'
PLUMBING ��, r 4
Post&Beam 04 �r� c tc t •r' i c,✓s �i lX� n c)
Under Slab �i/! u L /n /f{'c/y71 ryrQi' ale);
Top Out
Water Service CP / �(vv/fi, Jn1(fy�
Sanitary Sewer
Rain Drains 0/7-Zdf �j^��rf't� rAf
Final pLrsf h�2>�r� f�
PASS PART FAIL 67 v=�f„✓/ ti,a/� n�� ,mac:€ cr�i o,, ��f/��crnl
MECHANICAL � �`� c'c _ 7-' `�—
Post& Beam
Rough'n
Gas Line
Smoke Dampers
Final
PA is PART FAIL _
ELECTRICAL
Sarvice
Rough In
UG/Slab I _
Low Voltage
Fire Alarm — --- —
11
PART FAIL
SITE _
Backfill/Grading
Sanitary Sewer
Storm Drain I J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin I )Please call for reinspection RE'. I J Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sldewalk Date fC ' c^ � Inspector ! LO ��71C1C+_- Ext
Other
Final
PASS PART FAIL DO NOT REMOVE. this inspection record from the job site.
CITY OF TIGARD BUII r)JNG INSPECTION DIVISION MST)
24-Hour Inspection Line: 639-.. .15 Business Line: 639-41
BUP
Date Requested___, l AM /�✓ PM __-- Bb.D
Location ri --�� 7 7— 11 z��-rt -- _ Suite MEC -_
Contact Person 0zi-,tom - Ph _ �' ��, S_',� PLM
contractor Ph _ SWR 0
�'wner - --- SS-�� a
BUILDING Tenantiu
Reta ing Wall
Footing Access.
Foundation FPS
Ftg Drain - SGN
�A,Crawl Drain Inspection Notes: ----
Slab SIT
Post 8 Beam --_
Ext Sheath/Shear
Int Sheath/Shear --
Frarr.ing
Insulation -
Drywall Nailing
Firewall
Fire Sprinkler _
Fire Alarm
Susp'd Ceiling -- - --- ----- --------
Roof
Misc: — - -- -
Final
PASS PART FAIL - - -- ------ -- ---- - - ---
PLUMBING
U-14 Post 8 Beam --- ----- --------- --- ---_ __..__- -
Undor 61eb
C✓t-- Toa Out --- _.._...--
,Vk Watr..,r Service
,0- Sanitary§ewer
'Rain Drains
PART FAIL --
MECHANICAL
Post& Beam --_-- --- - -
Rough In
Gas Line - - - --- ------ -
Smoke Dampers
Final _ - --- --
PASS PART FAIL
ELECTRICAL - - - - -- - ---- - —
Service
Rough In
UG/Slab --__ -
Low Voltage
Fire Alarm
Final T
PASS PART FAIL
!lltE
--
Backfill/Grading
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ _ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]please call for reinspection RE [ ]Unable to Inspect-rm access
Fire Supply Line
ADP
Appronch/Sidewalk6 \ b\ __ - t
Other 08te Inspector _ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY of �IV��� _ ELECTRICAL PERMIT
PERMIT#: ELC2003-00124
DEVELOPMENT SERVICES DATE ISSUED: 3/12103
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103AC-07400
SITE ADDRESS: 12972 SW 113TH PL_ ZONING: R-4.5
SUBDIVISION: FONNER WOODS
BLOCK: LOT : 010 JURISDICTION: TIG
Project Description: 1 branch circuit far AC.
RESIDENTIAL UNIT TEMP SRVC/FEEDERS — MISCELLANEOUS
^1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OIJT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVCI FDR: 601+amps - 1000 volts: MINOR LABEL (10):
—SERVICE/FEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st WIO SRVC OR FDR: 1 PER HOUr.:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: — ` _ PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reronnect only: SVC/FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
RUSS OCHLER HILLSBORO ELECTRIC
12972 SW 113TH PL. 2.1 y5 NW EVERGREEN PARKWAY
HILLSBORO,OR 97124
Phone: 503-598-1047 Phone: 503-439-9666
Reg #: FLE 34-433C
--� I.IC 134481
FEES SUP 4240S
Description Date Amount Required Inspections
[FI.PRMTI ELC Permit ' $46.85
$3.75 Rough-In
I 'AXI go,,,State Tax "' Elect'l Final
Total - $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. 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 4 work is
suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952.001-0010 through OAR 952-001-0100 You may obtain copies of these rules urdirect questions to OUNC at 15031
2468699 or 1-800-332-23
Issued By: r. ti (A !1 1.('L FJLt i � ' Permit Signature:
OWNER_ INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _--_ _._. DATE:_ -
LICENSE NO: ----
Call 639-41 '5 by 7:00pm for an inspection the next business day
Dectrical Permit Application
7 Date received: Permit
Cigar of 1�rIlgard PmJxtlappl. E;jtpao dam:
(,,V,,/Tigard Address: 13125 SW Iia11 Rlvd,'I'igltrd,OR 97223 A1C„ gy;x Roctipt no.:
Phone: (503) 639-4111
Fax: (303)599-1960 1 Caw file no.: Payment typo:
Land use apptvval:
�1 l dt Z family 4welling or aa:msory ❑Commercial/in.ducttial Q Multi-family a,re flt jrn rovtmlent
j ]Ncw constnretion O Additiooialterstioo/replacernent 0 Other: _O Partial
ktb addrm: a, l Bldg.no.: I Suite no.: ITsix raw/tax lotla=o nt no.:
[Alt: Block- --- Subdivision:
Proe<t wane: scription and location of work on premieee: -
Fatimatod date of etionli tion.
StiMEKNIM'tMl __ - wnew
J*bNoa so Me
Ith
Business nacre: H i l l s b o r o Elect LLC H` T`61t m.
Now re■ib"d-daxqiIlsw wmM4,mffV rw
Addrena: 21165 NW Evergreen PkwY Ste 101 &,tamp,&bdk.r�
Ci State: M: 97124
�e..+rr t rtr+em
Phare 9— 6 6 6 Fax p -3 6 8 B-tttall: !Wo q t o_lye a _
L [xb■��uuaal X00 sq..ft.a l gMrec''
CCBDO.: 34481 Elec.bus,lie.ao: 34-499 - ----
1,mittd encr�y, re,uttenti■I 1
City/Marro lir..no.: Um{gat mmAiast�l 2
-- ,0 E.:h mvOwn,rod imm or modular dwoft
9 of 6APeiviiiiiii cloctooia■ (roguund) ' - DM 9,er rum md/or foodw _ 2
.elsot tam■(Rick Jaev V cco Lwow ao: 49415 So vkdowboda 4wouMadi ,
dtant]euwrektaft-
206 %or Im 7
Nam(prim): 201■mp■to 400 M 2
-- --- —-- sot"p to too
Mailingad�eas: but appe to■00otl.
Al! _
City! tate: I.IP over las►nPat"M - 7.
Phow:_ Fax: Ltnail. Reranncctanly1
Owner irtetallrbon. ]ate ineraibttion is being made on pinpar+.y I own t'rre■.+nw.trr.wtr.ro.
which is not intentled for Yale,lease,rent,or exchw*c according to t■Aadlauaw■unsrrlae,�r r.t■csdawr
200
ORS 447,453,479,670, 701.
201 an+ la 400-p2 _
t bunds si I3a:e: 401 to 6m amps 2
Pimm""eirvalls.t.aw,■faml..,
Name. «actoad""W pawl:
A Fac kx hnwh co ma.rr pumiamw%ud
s or fe■dw foe,o"nnr►ae cbmk 2
T Stam: Ip- _ a Fee fm butnch dr um .ehn purchM
Phone Fax. E-mail: of arviM or fVdff r n,,.�.�►oiW* v _ 1
WaddkkmW br_h Ch
Mist.f tltrtt-dtx watrrtiar set VduMrlh
O Savirp mare W WMrW4"erewnrW -3 11MMKwre ftdllry pirb pump a itti/slae ohtl■ 2
J{%viae nwfr 12D Witm""a,a 1 O ti■audmis bah —Fath aide or oudiw - 2
aimlly 4WOM t u Buil.Mtt neer I(ht=past ant Arr ■ lOQrl efetit(r)of a UWANd dp peel,
J S"wn me 000.olb aouOml nwn■reudaldd u*m In naa Mruclae allorwan, Q e7tMOtbaa �_�-_--- .. 2
r3 Sa WJ,r M"W thm.rnara U E:aa&Um 400 enre n mw. •p<tifl lao:
2 tki,grry ked o.of Y9 parsoy .!M■nu>letu,ri oncwen K R v'pal P� tf>• or do WLpmbb to oq et Aw*6 PC
7 P.a.n shfins p'" u,rw _ u a. _T_-1 E
ti■r.tl oat■ear pr w.Volla e.g of t►.4e... Inve■tlpaoa he
No Is AAwrie"Wb s,.tart,One mN hflaYlata tM taIetdWa tom: Tit pemdt a,,p►ieattian Permit fee......................S
O Vim O lijulWmd arq+h it a rmtnit to rxtr obtaki r.4 Plan review(at —_ 76) _
OWO CMA■■chic — wkWu 180 days■fter it hu been State suttharpe(tm).....f
Now$of r a a04epW as complete TOTAL............« w...,..S
---- sei�.i�
- -- -coo~ e X war"- wIN"13(GOM)
TO MkId 01810313 0808111H 089ET09E09 90:0T E00Z/TT/E0
CITYO F T I G A►.R� MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003-00113
13125 SW Hall Blvd., Tigard, OR 9723 (503) 639-4171, DATE ISSUED: 3/14/03PARCEL: 2S103AC-07400
SITE ADDRESS: 12972 SW 113TH PL
SUBDIVISION: FONNER WOODS ZONING: R-4.5
BLOCK: LOT: 010 JURISDICTION: I IG
CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APDL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS _ HOODS:
FUEL TYPES 0 3 HP: DOMES. INCIN:
3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PpE:,:.'IRE: 50 + HP: CLO DRYERS:
FURN < 100K B -U: AIR HANDLING UNITSOTHER UNITS: 1
FURN —100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Install exterior A/C. Do not install within the required setback(s)
Owner: FEES
RUSS OCHLER Description Date Amount
12972 SW 113TH PL. [ME('ll[ Permit Fcr 3/14/03 $72.50
[TAX] 8'!i,State'I;u 3/14/03 $5.80
Total g78.30
Phone: 503-598-1047
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS __
Final Inspection
Phont:: 503-640-3607
Reg #: LIC 66578
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Stat:; of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance. or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699. _
Issued By: - �� P � -�' _ Permittee Signature:
Call (503) 39-4175 by 7:00 P.M. for inspections needed the next business day
Mar 11 03 10316a Specialty Heating 503 5918 0718
Mechanical Permit Application PMMMMM�l
Date received: �. I G r
PClzttit no.n�i%G.,.i
City of Tigard —
CiryofnjrdM Address: 13125 SW Hall Blvd,Tigard,OR 97223 ProjwUappl.no.; Expire dale:- - -- -
Phone: (503) 639-4171 Date issued: By: Receipt:;,,;
[Sax: (503)598.1960 Case rale no.. payment type.
Land use approval. Building permit no. -
1 &2 fartuly dwelling or accessory ❑ otnmetriallindustrial ❑Mulu-tantily 0 Tenant improv:mens
0 Now construction .,d�litior✓alterution/rCpi.a�r.ntcnt 0 OdIeF.
JOB SITE INFORNIAtION
1 '--- --- -
hnir
lobaddress: �1_ ' (t_I 7_. Indlcata:quipmcrlr cuanancs in boxy.:,below, Lrdicat:fill-dollcv
-- ----
Bldg,nu.: - Suite no.: value of all mechanical marerials,equipment,labor.a verhead,
Tax map/tax lot/account no.: ptnfit.Value$
Lot Block: Subdivision: _ *See checklist for important applirntion information nd
Project name: j:� jurisdiction's fee schedule for residential p,stnrit fee.
` City/county. ZIP - - AM
t _
Description and lor, on of work on premises: 11014 / r
Fee((a.) 7blat
Est.date of completion/inspection: / O llt-wQiption Qty. Rest my Rr.,only
Tenant improvemeut or change of use AC:Is existing space heated or conditioned?Wyes O No Air bandling unit CFM Is existing space insulated? Yes Q No condiuonfn(site lanrtquired)
ItrraUon of r. sung system _ __
MMIANICAL 1 OIaCNCOItIptC330[3
Business name:.S'��/4f > A r State boiler permit no:
--. , �m rX6� a- HP Tons BTU/H
Address: p/ _c c._ )V0 <_ ;TOW D _ i smokedampen-Muct smo-c aetectors
City_ State: Zli'' /��. T eit pato 'site plea required) -
Phone: - GO E ax: $ -17f4 E-mail Tsta Urep acac`e-Ennalamer tt'( /H
CCB no.:
- - - Including ductwork/vent Ilner O Yes 0 No
_ ___ nota /rte ace rrlr�rateheatcn-cucpnndcd.
Cl /metro lie.no.:/ _ wall,or float moturtm
Name(please print)- or/11 —� �' ,¢j� Q L S entora Ian1' c'e oihm•than ulnare
emnon:
Absorpuonunits_ STUM
7(_ _
CWHeerss }{pOW, 'RO .D m Coressors HPi,/ �y� Stated ZiP: qIJ � oanrceta ex�tatsst pu •en o n:
Ap Mance vent
Phone.: �/a3Ge!Ihy-�iauat�-
�ooas,Type res, tehei/hazmat
turd r1rc supprc-33ion Ky stwt
Exhaust fan with single duct(bath fanst
Mailing ati tress: W / fc e- - aust system apuc from ti rinn,or A
City: �l State: 7�P ',2 2 piping a���Oo(up to ou c
Phone: Fax: E-mail; �Nijmb,rof
_-LPG -__ NO Oil
eac a tionp over 4ou Cts
tsg schematicrequ )
Names utlets
-- --.��-- ptTier�a'•d app'�oco or --
Addtess:
__ Uecorutivc fireplace_
City �Stnta: = ZIP: _ neem-ry -
Phvnc. — F E-mail- � �P5owtuveipe stove
Applicant's signature:: _ lope d
othm
Name(print): —
Nd dl pni.dlceow K""cleric coil,tueve call Juri"atim for Ittei.totb:an Permit fee................ ...$ r 7
0 via 0 Materf:ard Notice Tbls permit appllcatlon Minimum fee.......... .
Ctedu r rd number_ expires if a permit Is not obtained Plan review(at
within IRO days otter it has been
--- T' r o t r oa t accepted is complete.
State surcharge(896) ...g
sTOTAL .......................$
C _ _upnstrae Ataaw anOa:r[baotctln+>
Mar 11 03 10: 16a Specialty Heating 503 598 0'718 I°• 3
SITE PLAN GITY O�" ,►G�R`�
PL
BUILDING DIVISION
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PL
Pi_
IV
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PL
STREET
Specialty Heating &. Cooling, Inc
1601 SE River Road
Hillsboro, OR 97123
Phone 503.620.5-643 OR 503.640.3607
Fax 503.681.0743
CITY OF TIGARD 24-Hour —
BUILDING Inspection Line: (503)639-4175 MST _ —
INSPECTION DIVISION Business Line: (503) 639-4171 BUP
- a AM_ --_._ PM �— BUP
Received -- - Q Date Requested-3-------
e4,--- Suite
Location --- ---- MEC
Contact Person Ph
Ph( ) �1.__4-- SWR
Contractor__ - — ELC
BUILDING Tenant/Owner —
i -
ELC _
Footing - —- 7Foundation
Access: , 7ELR
Fig Drain
Crawl Drain _SIT
Slab Inspecti Notes:
Post&Beam - - -
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -
Firewall ---_---_—- -
Fire Sprinkler
Fire Alarm --
Susp'd Ceiling
Roof
Other:
Final -
PASS PART FAIL
Post&Beam
Under Slab —
Rough-In
Water Service — - -
Sanitary Sewer
Flain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan —
Other: _--_--
Final
PASFAIL —
01ANIC --- -- —
am - ---- -- �.
Rough-in
Gas Line
S Dampers
PART FAIL --- ----� --.__,-----
___CT_RICAL- -- — ----
Service -
Rough-In
UG/Slab --_._ - ----——
Low Voltage -
Firq.,Alarm
(1=m [� Reinspection tee of$ _ required before next Inspection. Pay at City Hell, 1325 SW Hell v
AS PART FAIL Unable to inspect-no access
Please call for reinspection t I
Fire Supply line Ext
ADA Date 3 /A Inspector
Approach/Sidewalk
Other:___ -- DO NOT REMOVE this inspection record from the job site.
Final
PASS PART FAIL