13575 SW 115TH AVENUE I '
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INNER
FCITY OF TIGARD _ _ _
COMMUNITY DEVELOPMENT DEPARTMENT MECHANICAL
13125 SW Hall Blvd.Tigard,Oregon 97223o8199 (503)639.4171 PERMIT
PERMIT #. . . . . . . : MEC94---0257
DATE ISSUED: 09/16/94
,.iITF ADDRESS. . . ; 13575 SW 115TH AVE PARCEL:
SUBDIVISION. . . . :
BLOCK'.. . . . . . . . . LOT. . . . . . . . . . . . . ZONING: R--4. 5
C-ASS IF WORK. . :ALT FLOOR FURN. . . .
TYPE OF USE. . . . :SEVAP COOLERE,
F UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY CRP. . :R3 VENTS W/o Appl-:
STORIES. . . . . . . . : VENT SYSTEMS:
FUEL BOILERS/COMPRESSORS HOODS. . . . . . . ..
0-3 HP. . . DOMES. INCIN.
- /GAS/ 3-15 HP. . . COMML. INCIN:
MAX INPUT: BTU 15-30 Hp. . • . :. . -
FIRE DAMPERS?. . : RE"PAIR UNITS:
30-50 HP. . . .
GAS PRESSURE. . . .- WOODSTOVES. . .,
50+ HP. . . . : CI-0 DRYERS. .
NO. OF AIR HANDLING UNITS OTHER UNITS.
FURN ( 100K BTU: 1 10000 cfm:
FURN ) -100K BYU: 10000 cfm: 13AS UU'TLE'TS.
Remarks : ELE2TRIC TO GAS CONVERSION -- FURNACE & WATER HEAVER
------
F?LJSL-. "LL TRAPP FEES
I "C-1 SW 115TH type alhoLint. by deAte i-ecpt
PRMT 250. 00 JG 09/16/94
I (GARD OR 9722 $ 1. 50';7 JG 09/16/94
(.',ontr-actor:
i-`URTLAND METRO-AIRr.-
.10010 SW BEAVERTON HILLSDALE HWY
'4EAVERTON OR 97005
11hune #: 626-7818
`(eq c,1jy!1q $ 26. 25 TOTAL
EQUI
'his permit is issued subject to the regulations contained in the Gas LineRInspRED INSPECTIONS
Tigard Muricipal Code, State of Ore. Specialty Codes And all other Mer-lianical IT,sp
applicable iaws. Ni: work will be done in accordance with Final Inspection
aapraved plans. This pervii will expire if work is lot started
.,ithin 180 days of issuance, or if work is suspended for tort
----
!Kan 180 days.
Pel�ritee - I &T
Call fat, inspection 639-41'75
City Of Tigard MECHANICAL PERMIT Planck/Rec. # — --__
13125 sw Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 539-4,171
Table 3A Mechanical Code _ CITY I PRICE AMT
Job r ,ti S �)� �� I�fih 1) Permit Fee _— 0- -0- 1000
Address �,Bc1: ""
2) Supplemental Permit 300
Furnace to
-TG"00 BTU
_ 1) incl. ducts &vents 0U ,
... / Furnace OO B I U' --
I n— (;j ( I 2) incl ducts &vents 7 50
Owner ur,ance
3) incl. vent 6.00
SuspenUPT heater, wall eater
A) or floor mounted heater 600
aninotIt-.F ii
Occupant .'• 5) appliance pen-nit 3.00
,�•,,, —' epsi�o teaUng, refrig.
6) cooling, absorption unit 6.00
of er or comp, eat pump, a,rr con —
�. 7) to 3 HP; absorp unit to 100K BTU 6 00
Boiler er or comp, eat pump, air cony
_ �� ♦alp 8) 3-15 HP; absorp unit to 500K B I U 11 00
Contractor o!G l of er or comp7eaTpump, air conc7—
�..(L11 �r ('?r, 9) 15-30 HP, absorp unit 5-1 mil BTU 15.00
CF Boiler or comp, heat pump, air con
{ •� } (a 'Z([�r J 10) 30-50 HP; absorp unit 1.1.75 mil BTU 22 50
ere y acknowledge that I have readtTi a apc nation,ll a e/ Boiler or comp, eaT purtlp, air cond.
information given is ro rect, that I am the owner or authorized I 11) , 50 HP, abserp unit 1.75 mil BTU 37 50
agent of the owner, that plans submitted are in compliance with it an ing unit to
State laws, that I am registered with the Construction Contractor's 12) 10.000 CFM 450 —_
Board, that the number given is correct. (If exempt from Stateit an rng unit
registration, please give reason below.) F1 3)
10,000 CTM + y -i 5C
Nonportable
14) evaporate cooler A 50
Vent an connected
15) to a single duct 300
— anti anon system not
16) included in appliance permit ^50
Hood serve y
17) mechanical exhaust _ 4 50 ,
ITesc'rite wo new addition--U—alteration repairCommercial or industrial
to be done resiaentlal p non-residential Q 18) type incinerator 3000
Existing use o
Other i.e, wo stove, water i —� 450
building or property % r, t e) 1 1 �,� 19) treater, solar, clothes dryers. etc
--
Proposed use of 20) Gas piping one to four outlets _ 200 —
building or property _
21) More than 4-per outlet _—
Type of fuel -all O natural gas,,A LPO Q electric QNOTICh
Minimum Fee $25 00 SUBTOTAL. _
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED tri 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 — --
Date tssued —by
k.MFrHPMT
n,,,d�eemM,
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION#350-12
COUNTY, 155 NORTH FIRST, HILLSBORO, OR 97124
OREGON PHONE: 503/640-3470
INSPECTION REQUESTS (24 hours): 503/64fl-3561 or 693-4415
.•:XXX:{XXXX----> 640 _ 34'/('
Page
Date c)y ✓21f:�'1
Permit 'Type t-te:side Tim..' 1.4 : 1U
ntietl l~lect.. ir_a.t t'�1;: it Permit. ## 05'jl)8 ')8
t•'Uxrn:it Status AP!'ktUVfw,;
!. it.u.S Address 135 /; ;:;W 1115,1"H Av '1'.l. Applie,:i W4el21/94
V rmit Titlels:3uec:i 09/21/94
F'!< -- UNl; C'J.ktc.;L11'i'
Permit Descr . k'UktNAC'L CcymE•,.teter_3
Project lliklr, )Fkt 'k: C'1 tt l't.t 1'ii'e Lxrixr(- ()3/21),,,95
C)CY ' r,�_a �,f, a �
Project De:;cr. EURNACL j t- # F 0U 1 3,4il
EROSION A
Parcel Numtye;r 2611'l --
Valuation Land U c: ui �trif t,
' c,
Legal Ve:scr ,,
OWner 1Nbk't;C'1'1(.)1J .. TIGARD
Applicatrt N:am� POR'TLANu ME'.i.'RU AIRE t_c,r►str'uc�tiot r,'t"Et
AppliC�ULt. Addr- . 10010 SW ij'LAV El1Ll.,LiDALt:: ;i'r,Y f: , if,iC'clt;,rtl
Ctlec*rs;f;,`uF;.a r'L c y
E3kAVE:t3'i'UN
At)E1 gyo(,,3 "'alidater:i by
�:�K>1.ic:�:trlt 1'hcme� : E,2t,. "lFa1K
11:31?ectox Ax (,
CUN'1"RACTOR : PURT ,I i;V M1::'!RO AlRL
Wee C�1?til;� 1Eyt.1(fS: 1'i� C ,!4 it)'/C 6 - Ml 8
tlr;itE. Fee/Ur:it Lxt ff�fa
1,5t B- arch W/cut
`441::t0t.Al Electricalf^r-.cN: ' 0Q 3!i1. . C„
t,.,tL ;;u'rrhrctrat' t, 35 . Uti
' 1'ot;al E:;lectrictAl Fee u: 1 • 'I`,
P:x
. Coilectod
Cx
1 t•^�
method ,: k btt.e ,
6 aytn�rf t.
q. (:h
04/2 1/9 4 36 , 1`
TOTAL 'if La L ITL
AA A-AA A 30 ,
Ad,)Un;tInettlt S
Total Fees : J6
. 0t
i
i
v,J a
WASHINGTON
partme tof COUNTY ELECTRICAL PERMIT
Department of Land Use & Transportation
Ele:ctr..al Inspection Section
ilAvenue,
350-12 APPLICATION
Hillsboro, Oregon Oregon 9712q
Informat"on: (503) 640-3470 Fax: (503) 693-4412
Permit ,. ) X , !/,
Number —_ wl- -1 DateP10000 C�jrp�ete all sections, fthrou#ft 5.
4. Complete Fee Schedule below
1. Location of installation Number of inspections per permit allowed
Address 1 iJ W f I — Service included: Items Cost(ea.) Sum
Buildingg A. Residential- per unit
City / ,�-�� _ Suite N0.
i 1000,q.n.or less $110.00 4
Tenant Name r_ach additional 500 sq.ft
(if commercial) — or portion thereof $25.00 --------
Limited Energy $25.00 1
Map No._ fax Lot Each Man,if'd Home or Modular
Dwelling Service or Feeder $68.00 2
Thomas Mar Bpok: Page:� Section:. _
Directions a 4 L r ea a t,;j 1' 3 t, — -- B. Services or Feeders
Installation,alterations or relocation
200 amps or less $60.00 2
Commercial ❑ Residr�ntial�� 201 amps to 400 amps .__ $80.00 2
401 amps to 600 amps $120.00 2
2a. Contractor installation onl : 601 amps to toxo amps $140.00 -- 2
Y Over 1000 amps or vats Y340.00 2
Electrical Contractor _ Al z t 1 r_.' �1 I Reconnect only ____. $50,00 2
Address 10i', lid 0 i -Sc In,1e
City v State a ZIP J1 r C, C. Temporary Services or Feeders
Date ' T. Job Nurgl;er Installation,alteration or relocation
Property Owner 1 N t[Ss e i Ti rt 1P�— 200 amps or loss $50.00 _ 2
Contractor's License No. 1 F 201 amps to 400 amps $75.Or> 2
Contractor's Board Re N0, 401 amps to 600 amps $1 J10-1`10 2
�. , -- Over 600 amps to 1000 volts see'B'above
Signature of Supr. Elec'n �_ D. Branch Circuits
License No. Phone'3 '' No. �
• 1 _J _ 2 New,alteration or extension per panel
a) The fee for branch circuits with
2b. For owner installations: purchase of service or feeder Ise.
Each branch circuit $5.00 _ 2
riotOwner's. ams
—------------ b) The fee for branch circuits without
Ona o.
purchase of service or feeder lee.
A rc-TrT-ass.— ---------- - - _.��_— - --
First branch circuit —L $35.00 3:2 _
Each add'nl branch circuit _ $5.00
E. Miscellaneous (Service or Feeder not included)
Each pump or irrigation circle___. $40.00 2
The installation is being made on property 1 own Each signor outline lighting _ $40.00 _— 2
which is not intended for sale, lease or rent. Signal circuit(s)or a limited
energy panel,alteration
Owner'u Signature _ _ or extension $40 o0
F. Each additional inspection over the .11owable
--- in any of the above
3. Plan Review section (if required) Per inspection _— $3500
Per hour $55.01:
Please check appropriate(tent slid enter fee In section FB. ,lit $5500
�4 or more residential units M one structure -
�Service and feeder, 800 amps or more 5. FE'GS
_—System over 600 volts nominal A. Ei,lr? total of above fees $ _
__"-Classified area or structure containing special 5% Surcharge (05 X tc'.il fees) $
occupancy as described in N.E,C. Chapter 5 Subtotal $
B. Enter 25% of line A for
Submit 2 seta of plans with application whe►a any of ,he Plan Review if required (Section 3) $
above apply. Not rent.Ired for temporary construction Subtotal $
sPrt'7es. ❑ Trust Account $ _..�
- Balance Due $
For Inspections call this permit becomes null and vold If the work authorized by the Permit I@ not comniamrsd
640-3561 or 693-4415 within 160 days from data of Issuance of such permh or 0 the work authorized is
auepended or abandoned N any time after work Is commenzed for a period of 1 W days.
24-hour recorder, one working day in advance of need fbciricalPermits are non-refundable and non-translerabht.
8194
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION 91350-12
155 NORTH FIRS-f, HILLSBORO, OR 9.7124
�.OUNTY, PHONE: 503/640-3470
OREGON r � INSPECTION REQUESTS 124 hours): 503/640-2561 or 693-4415
V
Permit #: 05058508 Project #: P0043941 Status APPROVED Fuge 1 of 1
Applied : 69/2.1/94 Issued 09/21/94 Expires 03/20/95 39/23/94 06 : 35
;2ESELEC
Permit Title SFR - ONE CIRCUIT OTH
Description FURNACE Bo4jun: 09/21/94
Job Address 13575 SW 1.1.5TH AW TI
Owns Name INSPECT70N - TIGARD Region
Appy °.cant Name PORTLAND METRO AIRE
Phone number 626-7818 Valuation : 0 Approved__,
Inspector Comments : Rejected
IVR-RESULTS
_--_-- _001,
REQUEST ERROR !
Inspected by --� ----- - __ Date : -
0 3
ate .03
Inspection History Summary:
* Cover & Service 0403 E AP 1')N CJI
09/23/94 RI TW AFTER 3
DEPAFtT.AENT OF LAND USE & TRANSPORTATION
LAND DEVELOPMENT SERVICES DIVISION #350-12
WASHINGTON 155 NORTH FIRST, HILLSBORO, OR 97124
COUNTY, PHONE: 503/640-3470
OREGON INSPECTION REQUESTS (20, `-^urs): 503/640-3561 or 69"-44115
Permit # : 05058508 Projt.c:t # : P004-1941 Stat'-IS APPROVED Page 1 of
Apr�-lied : 09/21/94 If;suec: : 09/21/94 Expires 03/20/95 09/29/94 06 : 3.'
RESELEC
Permit Title SFR - ONE CIRCUIT OTH
Description FURNACE Begu;1 : 09/21/9
Joy: Adc;7-e--s 13575 SW 115TH Alt TI
O,aner Name INSPECTTON - TJGARD kegi�n
F,pplicant Name PORTLAND METRO AIRF:
Phone number 626-•7818 V,Aluati.c�n ; U AE,F,r :>v �3-_..--_•--•-.
Inspector Con��nents : \r jecte ......
_...
IL "`�--
f'b! TVR R E:.U 1 T
REQUEST ERROP '
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0'1/2.9/94 RI TW
09/23/94 RI TW AFTER 3
^ 173/94 DN KP DNIVR Ltll"', I R
DEPARTMENT OF LAND USE & TRANSPORTATION
WASHINGTON LAND DEVELOPMENT SERVICES DIVISION #350-12
155 NORTH FIRST, HILLSBORC, OR 9717.4
COUNTY, PHONE: 50311640-3470
OREGON INSPECTION REQUESTS (24 hours): 503/640-3561 or 693-4415
jW&
ItiSPECTION NOTICE `
City of Tigard Buildi.nq Oepsctmant
13125 SA Ball Blvd. Tigard, Oregon 97223
Inspection Line (Ree-O-Phone): 637-4175 Business Phone: 639-4171
7
Inspect Lon:
Footing Plbg. Undernlab Nech. Rough-in Appr/adwlk
Found, Plbg. Top Out Gas Line
Post/Bea„i Struct. San. Sewer Framing
Pout/Beam Nerh. Ra"n Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. l -Mach n
l P7ri�7C
L.. Requeitted:__ 1,_/ ____c- —'�/r'7 �im(`at �/I_ AM 7J�.CPI�
Addreese//�`� t J e /f / V✓ //PeimIA, Gl !
B:L Lder:lam.[y--s u t 1 !. �li (1' - ,
TIM IOLLOWING CORRECTIONS ARE REQUIRED:
_�Y__�,.�-!/�L- //✓�j7cTL'T%Q /� c.J/7 lf./��TLrsi+�.l�G�.�l�
4t/��L- ��RT�s/'�. e4/fin t117�tt�S r��
Zd
t_
Inspectors r
C.V PROVED DISAPPROV11D APPROVED SUBJRCP To AB•1VE
___ Cull For Rainnp.