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14105 SW 117TH AVENUE �.s ADDRESS: P sw I I 7rtiAv ,. o_ 'r J l:\records\tnlcm f lm\targets\buiiding.doc w J 0 O r U 7 N O O O C a� 0 0 a, a L _y $n Ti 0 a� 0Ea a .gym is -Pa, n o m W U) ami ' mp w a o co E � �— c O m d O Q,$ Ly'C c �. W p O C C_ U O O O Z M $ a F.E o i Z U m rn a, 10 Q 1) rn rn m CL � rn o`� rn ai rn rn o, rn v w M Z 2 = 2 Z am O p '� p E E, CL v > O y T J M 00 M O a O W J J W fn N N N U Z Q Z cn N N C Ci Q LL u_ d d d co CY) m W c m m C!] Q c O q ^, O, Wqj Q w O YO 4 `vr � � 7 0 p rn a`s rn rn v' rn m rn N > o V CL o r a € " a LLIa ° am N m a, $ n ro d u '� d c �_ N J N y M y ca,- f0 N GT Q U LL M o o rn o LD o Cl) Cl) O U r r• o r` ou W W W W W w W W } § $ m k k § $ 7 f \ a § § a a § \C CL � �> 2± � a) m ƒ / \ 2 g k G a /± ƒ§ ± C& a m L)LLJ k j \ ) it ( ) CD0 / K � / m § � � $ � � $ % 3 & k a / Ln � e / 7 = t S } § -jf ) & ) A ecu CL ) $ ) E Cl) f f ) < ( 6 < 7 k C) w ] 7 w § E \ z ® § » / \) \ \ \ƒ\ or )® /)\ 0 � � k{ { z /f E 5 (D 4) ° ° m $ 2 $ M $ $ a § \ CIL I a % ¥ a & \ § M CL o c ® o 0 � 0 )\ 0 z . � _ CD n u uu @ 00 \ U \ j \ 9 a) @ m m m a J § § g ƒ ƒ c \ 2 � \ ° $ § $ § c C) a a ¢ $ A $ .§ 04 > j CL � m � 2 2 3 2 ) d § § { ) $ \ ƒ a f \ ¥ / / p _ v C) k \ k ) / / \ c / G S E w = a \ » G \ m ¥ 2 e S $ ) | k < k k \ k k \ 2 2 2 ct a ¥ ¥ CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 BUP _ __Date Requested_ `,, AM PM BLD Location �� - ����`� ��'`� Suite MEC Contact Person Ph Contractor Ph — SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation �ao Ccs FPS Ftg Drain SGN _ Crawl Drain Not Requested -- SlabFound During Research — SIT Post&Beam _-- Ext Sheath/Shear No Insnertion(s) In File — Int Sheath/Shear — Framing --- Insulation Drywall Nailing __- —_ --------.---- Firewall Fire Sprinkler ____-- --- _..._,_.-- - ------- --- --- -- Fire Alarm Susp'd Ceiling ----- --------- — -- Roof Mise - Final PASS PART FAIL ---- - -- -------._.------ -- --- ---^T -- PLUMLING 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 Final --- --------- ---- - -- - -- ---- PASS PART FAIL ELECTRICAL _ --- ---._ - - ---- - - -- Service -�1�►s/ Rough In UG/Slab - _----- — - - -- cc Low�oltage 'n Fire Alarm - -----— - -- -- - --- Final ` PASS PART FAIL -------- -- ----- — - -� SITE Backfill/Grading - -_--- — w Sanitary Sewer -' Storm Drain ( ] Reinspection fee of$_---_—T required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin I Please call for reinspection RE — ( Unable to inspect-no access Fire Supply Line - -- ADA Approach/Sidewalk Date Inspector Ext Other --- ----- ---- Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 U_ BUP Date Requested- / _ M PM BLD Location �/ 0. (56t) / 7 7 i 2 _ Suite MEC Contact Person -� Ph v� — PI.t, ! - Contractor --- (kG%'?L ce- &XtrL2 Ph SWR — FUILDINGTenant/ ,net' �d Liu' ELC — - Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN -- Slab - SIT Post&Beam -- Ext Sheath/Shear Int Sheath/Shear / - -- Framing _-i� S=� "r✓1 5 0lu ►D Q P - Insula+.ion —� Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: ------ -- — -— - ---- Final PASS PART FAIL --------- — PLUMBING Post&Beam ^--- - - Under Slab Top Out — -..--------__ -- - --- - -- -- Water Service _ Sanitary Sewer - Rain Drains Final — PASS--. FAIL- ME HANI AILMECHANI Post& Beam ----- - - ---.^-- S;Ingke Drrpers S PART FAIL EL RICAL Service _ Rough In 2 UG/Slab -- -_.----_ � Low Voltage —� f- Fire Alarm Final - ----- - - - --- --- ----- PASS PART FAIL - -, SITE _ Backfill/Grading ---- -- - --- - - — Sanitary Sewer Storm Drain [ J Reinspection fee of$— s required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ )Please call for reinspection RE: _ -- [ j Unable to inspect no access Fire Supply Line - ADA Approa&./Sidewalk Date _ Inspector Er. Other -- p — -- Final PASS PART FAIL DO NOT REMOVE this Inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 63 71 �C �MST 22 (f ✓ L BUR �J Date requested— C�^ AM ^ PM BLD Location 7f Suite r -7_ CM �� Contact Person 1/ Ph �� �`f O / PLM Contractor^ j 6 �� t ph SWR BUILDINGTenant/Owner ELC _ Retaining Wall ELR _ Footing Access: _ Foundation FPS Fig Drain / - -`� - Crawl Drain Inspection Notes Slab : C�� SGN 1 SIT Post& Beam - Ext Sheath/Shear {� Int Sheath/Shear Framing _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc Final - PASS PART FAIL —,--,----- -- _ PLUMBING Post&Beam — - - Under Slab Top Out -� - -- - Water Service _ Sanitary Sewer _ Rain Drains Final - ---- --------------_.___ _.� PASS r-ART FAIL MECHANICAL Post 8 Bearn -- - ---------- — Roug, Gast -- 5meke.pan ipers t•'AS� PART FAIL ftltTRICAL --- -_ -- Service Rough In ------ - UG/Slab � Low Voltage --------- Ul' Fire Alarm _ > Final ~ PASS PART FAIL SITE Q13Backfill/Grading -- - ------- -- -~-- _- Sanitary Sewer Storm Drain ( ]Reinspection(Pe of$_ —required before next inspection Pay at City Hall, 13125 SW Hari Blvd Catch Basin Please call for reinspection RE. Fire Supply Line I [ p _ —� __.___ [ ]Unable to inspect no access ADA f Approach/Sidewalk p Date ` Inspector �, Ext Other Final - PASS PART FAIL DO NOT REMOVE this Inspection rec e-d from the job site. CITY OF T I G A R D MECHANIrn: DEVELOPMENT SERVICES PERMIT 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 PERMIT #. . . . . . . DATE ISSUED: 09/11/98 PARCEL.,: 2S1. 10BA-01L'?00 SITE ADDRESS. . . . [/it'AS 914 117TH AVS SUBD I V 13 1 01\1. . . . : ZONING- R-7 BLOCK. . . . . . . . . . . L(:-'T. . . . . . . . . . . . . . JURISDICTION: URB -------------------------------------- (-L.ASG OF WORK. . :OTR FLOOR FURN. . . 0 EVAP COOLERS: 0 TYPE OF USE. . . . :SF UNTT HEATERS. . : 0 VENT FANS— : 0 OCCUPANCY GRP. . :R-- VENTG W/O ADPL: 0 VENT sysTEms. @ STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL 0,---3 HP. . 0 DOMES. INCIN: 0 GAS 3-15 I-AP. . Q.) C'OMML. INCIN- 0 MAX INPUT: 0 BTU 15---20 HP. . . . 0 REPAIR UNITS: 0 FIRE DAMPERS?. . : 30-50 HP. - - 0 WOODSTOVES. . . 0 GAS f--)RESGURE. . . 50+ HP. . . . : 0 CLO DRYERS. — 121 NO. OF AIR HANDLINGY UNITS OTHER UNITS. : I FURN ( woK BTU: o 10000 cfm : 0 CTAS OUTLETS. : 0 FURN > =IIZIOK STIJ: 0 10000 cfm: 0 Remarks : Installation of natural gas insert, already piped for gas. Owner. FEES ERIK ANDERSON type afn 0[A Tit by date recpt 1/1105 SW 117TH PRMT $ 25. 00 DEB 09/11/98 98-309051 TIGARD OR 97224 5PCT $ 1 . 25 DEB 09/11 /98 98-309051 Phone #- Contractor: T & K MECHANICAL TIMOTHY 9 WYNNE 11525 1733W (",ANYON 26. 25 TOTAL BEAVERTON OR 97005 Phone #: 626-4652 Reg ii. 00121. 1 PEQUIPED INSPE.CTIONS This permit is issued subject to the regulations contained in the Mechanical Tnsp Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection applicable laws. All work will be done in accordance with Final. Inspection approved plans. This permit will expire if work is not started within 160 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon LItility Notification Center. Those rules are set forth in OAR 952-00I-0010 through OAR 952-0014060, You may obtain copies of these rules or direct questions to OW by calling (503)Ph5-9187. 15'A e y : Permittee SignatUrP : al'W_4�/"clat- .............4-+++4-++4-++++4-++++4.......................f..............4-+++r++++-+ Call 63'j- 4175 by 7:00 p. m. for inspections needed the next bl-Isiripss day ..................4............4.....................................IF..........44 Plan C sf -- CITY OF TIGARD Mechanical Permit Application Recd x - 13125 SW HALL BLVD. Commercial and Residential. Date Recd TIGARD, OR 97223 1,;�8 Date to P.E. (503) 639-4171 X304 Dace to DST - �„.,,..r... _ - 1 Permit# 771/ Print or Type V`' colied Incomplete or illegible applications will not be ac epted Name of Devetopmerivro)ect ^T Descnption Table 1A Mechanical Code OTY PRICE PRAT Job Stroot Address Suit" A) Permit Fee 43- -a- 10.00 Address S" Citylstate zip 1.) Furnace to 100,000 BTU 6.00 includir.9 ducts&vents Name(or name of business) 2.) Furnace 100,000 BTU+ 7.50 Owner 11 VA( Q y, ())1 L Y I F including ducts&vents MakVAddren 3.) Floor Furnace 6.00 G) c-I w 7tL 4 U including vent C estate Zip Phone / 4,) Suspended heater,wall heater 6.00 TWO �V U- 07 or floor mounted heater or icon of business) 5.) Vent not included in appliance permit 3.00 Occupant Matkq Ad&%" 6.) Boiler or comp,heat pump,air Gond. 6.00 _ _ to 3 HP;absorb unit tu 100K BUT" _ Ciiyrstat• 'zip Plane 7.) Boiler or comp,heat pump,air Gond. 11.00 Cityirstate -7 3-15 HP;absorb unit to 500K BTU" Contractor Norn°/ ^ NOT'SAL&7- 8.) Boder or comp,heat pump,air cond. 15.00 (Prior to 14 /'i 'i�C OW-141a 15-30 HP,absorb unit.B 1 mil BTU" issuance MaWng Addram 9.) Boder or comp,heat pump,air cond. 22 50 applicant 30-50 HP;absorb unit i-I 75md BTU'" must provide all SKY6tate zip !Phone 10.) Boiler or comp,heat pump,air cond. 37.50 contrado Z Es2lo• / >50 HP;absorb unit 1.75 mil BTU- license fn rtnation Drop,I�(�Cant oars Lx:ti _ E.l�� 11.) Air handling unit to 10,000 CFM -� 4.50 ,� e for COT COT Business Tax or Metra N Exp.Dae 12.) Air handling unit 10,000 CFM 7.50 database). 0 _ Architect Nene 13.) Non-portable evaporate cooler 4.50 Or M2dej Address 14) Vent fan connected to a single duct 3.00 En,jlneer City/State zip Phone 15.) Ventilation system not included in 4 50 appl.once permit _ Describe won. New O Addition O Alteration Repair O 16.) Hood served by mechanical exhaust 4.50 to be done Residential O Non-residential O _ Additional Description of work 17.) Domestic incinerators 7.50 18) Commercial or industrial type 30.00 _ Incinerator Exts�urtg use of �' ____- - 19) Repair units 4.50 building or proFerty �� 20) Wood stove 4.50 Q Proposed use of Sn 21 ) Clothes dryer,etc 450 1�- building or property 22.) Other units 1 4.50 NO b-11VOP COO Type of fuel-oil 0 natural gas P. O electnc O 23.) Gas piping one to four outlets 2.00 -Jos t N. W C O L !hereby ackrowledge that I have read this application,that the �^ 24.) More than 4-pAW outlets(each) .50 information gtven is correct,that I am the owner or authorized agent of w - -- w the owner,that plans submitted are in compliance with Oregon State CITY SUBTOTAL laws. Signature of�1(Rl 1 gent / CIA 'SUBTOTAL ,,o <_A� r 5%SURCHARGE _ _ Conte P rson Name Phone PLAN REVIEW 25%OF SUBTOTAL - 5 °* TOTAL i\dstVnechpmtdoc (rry 9 'Minimum permit fee is S25 4 5%surcharge "Residential A/C requires site plan showing placement of unit. CITY OF TIGARD DEVELOPMENT SERVICES P,LUMBING F,ERMIT 13125 SW Hall Blvd.,Tigard,OR 97223(503)639-4171 r.,ERMIT #. . . . . . . : PILM98-0310 DATE ISSUED: 09/04/98 PARCEL.: 2S110Bn-01,:?'00 SITE ADDRESS. . . : 1/11.05 SW 117TH AVE SUBD T V I S 1019. . . . : ZONING: R-7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . JURISDICTION; URB CLASS OF WORV1. . :OTR GARBAGE DTSP,C)SALS. - 1� MOBILE HOME SPACES. 0 TYPE OF USE. . . . : WASHING MACH. . . . . . : 0 BACKFLOW F,REVNTRS. . : 0 OCCUPANCY GRP,,. . : R3 FLOOR DRAIN`). . . . . . . 0 TRAPS. . . . . . . . . . . . . . . 0 STORIES. . . . . . . . : 0 WATER HEATERS. . . . . : t CATCH BASINS. . . . . . . : IZI FIXTURES------------------- LAUNDRY TRAYS. . . . . : ID SF RAIN DRAINS. . . . . : it SINKS. . . . . . . . . . 0 1_)RIN(-)LS. . . . . . . . . . . : 0 GREASE TRAF-17. . . . . . . : 0 LAVATORIES. . . . 0 OTHER FIXTURES. . . . : 0 TUB/SH0i,1ERS. . . 0 SEWER LINF (ft ) . . . : 0 t4nTFR CLOSETS. 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . . 0 RAIN DRAIN (ft ) . . . 121 Remarks : Conversion of water, heater- to gas. Owner-: FEES ERIK ANDERSON type amoi.int by date r-ecpt 14105 SW 1171'H P,RMT $ 25. 00 DEB 09/04/98 98-308891 TIGARD OR 97224 5PCT s 1. 25 DEB 09/04/98 98-308891 Flhore #: COTIt t-a Ct CnLUMBTA HEATING & COOLING INC GO BOX 230397 8900 SW BURNHAN ST STE E-110 TIGARD OR 97281-0397 -------------- Flhone #: 624-2704 26. 25 TOTAI_ Reg 00001717 ------- REDUIRED INSP,ECTIDNS This permit is issued subject to the regulations contained in the Misc. Inspection Tigard Municipal Code, State of Ore. Specialty Codes and all other Final. Inspection applicable laws. All work will be done in accordance with approved plans. This permit will Px,nirp if work is not started within 180 days of issuance, or if work is suspended for Yore than 180 days. ATTENTION: Oregon law requi-es you to follox rules adopted by the Oregon Utility Notificatiin Center. Those rules are CC set forth in DAR 952-0001-001e through DAR 952-0001-0080. You may obtain copies of these rules or direct questions to OIJNC by calling ;5031246-1987. Is st ed By : Permittee Signat C� ++4+++4--4...................++-1......4.......................... +++++++++-i-+++++++ �+ + Call 639--4175 by 7:00 p. m. for- an inspection needed the next bi-tsiness day ++++++i-+++++i•+++++++++++++++++++++.-F++++++++++++.+++++++++++.....4.........4-++++ CITY OF TIGARD Plumbing Application Rec'd9y Y< 131'5 SW HALL BLVD. Commercial and Residential Cale Recd TIGARD, OR 97223 Cale to P E. (503) 639-- 171 Date to DST _ Permits Print or Type Related SWR s +-••/ �/ Incomplete or illegible applications will not be accepted called_ Name of ect CevelopmenuPro1 FIXTURES (Individual) QTY PRICE AMT Job �/ IC�P�5011 Lav Sink 9.00 Address Street Address Suite Lavatory 1t - �c,,-) //%]fit- Tub or TubrShower Comb, 9..900 i 00 I Bldg a it late Zip Shower Only — 3.00 (��� Water Closet 9.00 Nam4, waser ,S f Disnh �— L I 1 _ 9.00 � Owner Mading Address Suite Garbage Disposal _ � 9,00 i Nasnmg Machine 9,00 CIplrStale , Zip Phone Floor Drain 2" 9.00 Na 3 900 L �-�- 4" 9.00 Occupant %44"Address Suite Water Heater � 9.00 Laundry Room Tray 900 C.tyiState Zip Phone Unnal 9 00 N Oth61 er Fixtures 1SpecitYl 9.00 _ 9.00 Contractor �lin9 ddress Swte 9.00 ,t uState Z' Phone 900 .; - z 3.00 � Ore* n C nst.Cont.Board Lic.s Exp.Date 9.00 Mitch Cowl of ' G_ -qy 900 C' Plumb ng Lie.0 j Exp.Date Sewer• 1 st 100' Lia30 00 i .nwe _ .' IPJ _ -- Sewer-each additional 100' 25.00 COT pusiness Tax or Metro Exp.Date t LVater Service- t,t 100' JO 00 iName Water Service-each additional 200' _ I 25.00 Architect Storm S Rain Drain- 1st 100' 3000 1 or I Mailing Address S, ;e Storm&Rain Cram-each additional 100' I 25 00 I I ' Mobile Home Space I 2500 � Engineer I C,twSlate Pip Phone Commercial Back Flow arevention Cevice or anti- I -500 Pollution Cevtce Describe work New 3 Addition O Alteration53 Repair O Residential Backflow Prevention Device' 15 00 b be done: Residential O von-residential O any Trap or Waste Not Connect9ed;o a Fixture 00 AdorbnrW descnpt,on of work Calm Bann _ 3.00 insp of Existing P!umbin9 I I AO 00 Soeciaoenhr Ent"use of uy Requested Inspections � � 4000 xisldirq or propem oenhr y -- Ram Crain singie'amily,welting 30.00 �-_ Proposed use of Grease Traps J I d,00 building or property I QUANTITY TOTAL Are yCL capping. moving or replacing any fixtures? Yes C) No 0 Isorretnc-Y nser_ugram s reauvea A Cuanay Totals >9 t� (If res see back of forml 'SUBTOTAL -J I he,eby acknowledge that I ha-.e read this aepllcation,that the information I given.s;ormct. 'nal I am the owner or authorized agent of the owner.and 5% SURCHARGE :Mat pians ubmitled ar n' mollance with Oregon State Laws. 1, 31gn wneriqsn Date PLAN REVIEW 25% OF SUBTOTAL :F@OUirlE OnN'r fi7flUR 71V 'Yat 7> TOTAL �dntac ere�n Name Phone 'Minim Prevention perCevi rt he s 525 • S- %surcharge except Resaenuat Backflow urr l l '�t� �✓ Prevention L'evtce which s 515 .5°S surcharge I Wststptmapp doc 9198 PLEASE -OMPLETE AS APPROPRIATE TQ PROJECT: . . Fixtures to be capped, moved or replaced Qty Sink Lavatory Tub or Tub/Shower Combination Shower Only _ Water Closet Dishwasher Garbage Disposal Washing Machine Floor Drain 2" 3" Water Heater Laundry Room Tray Urinal _ �- Other Fixtures (\Specify) COMMENTS REGARDING ABOVE: w CITY OF TIGARD MECHANICA'_ DEVELOPMENT SERVICES PERMIT 13125 SW Hall Blvd., Tigard,OR 97223(503)639.4171 PERMIT #. . . . . . . : MEC98-0383 DATE ISSUED: 0'3/04/'7-48 pARCEL: 2S1l0BA—Ct200 SITE ADDRESS. . . : 14105 SW 117TH AVE SUBDIVISION. . . . : ZONING: R­7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . . JURISDICTION: URB CLASS OF WORK. . :OTR FLOOR TURN. . . . : 0 EVAP, COOLERS: 0 TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUF-IANICY GRF-1. . :R33- VENTS W/O AF-IFIL: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMVIRESSORS HOODS. . . . . . . . 0 FUEL TYPES-­----------------- 0­3 Hp. . . . : 'D DOMES. INCIN: 0 COMML. INCIN: 0 .GAS 3-15 Hp. . . . : 0 MAX I NFDUT- 0 BTU 15--320 HP. . . . . 0 REPAIR UNITS: 0 FIRE DAmr,ERS7. . : 30--50 HP. . . . : 0 WOODRTOVES. . - 0 GAS PRESSURE. . . : 50+ lip. . . . : 0 CLO DRYERS. . : 0 NO. OF UNITS------------ AIR HANDLING UNITS OTHER UNITS. : 0 TURN ( 100K BTU: 0 10000 efla: 0 GAS OUTLETS. : I FURN ) =100K BTU: 0 10000 rfm. 0 RemAt-[(s : Installation of gas piping for conversion of water heater to gas. Owner: ------------------------------------------------- FEES ERIK PNDFRSON type arnoi.knt by date r-ecpt 14105 SW 117TH I-IRMT $ 25. 00 DEB 09/04/98 98­308891 TIGARD OR 97224 5r-,CT $ 1. P5 DEB 09/04/98 98—.308891, I--'hone #: Contractor: --------------------------------- 1]'OLUMBIA HEATING A. COOLING INC. P-10 BOX 2'30397 ------------------------------------- $ 26. 25 TOT% TIGARD OR 97223 Phone #: (✓211-2704 Peg ff. 000763, RFQUIRED INSFIFiCTIONS This permit is issued subject to the regulations contained in the Gas Line Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. ln5'-er_tion applicable laws. All work will be done in accordance with Final Tnspertion 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 o adopted by the Oregon Utility Notification Center, Those rules are set forth in OAR 952-e8I-001@ through OAR You may 2btain copies of these rules or direct questions to OUNC by calling 1503)246-9187. s s 1.i Cey : I a r-lpr-mittee signatio - f.++++++++++++-+4......4-++1-+4... ..............4.......J....... .......................... Call 6,39­4175 by 7:00 p. m. for inspections needed the next btisiness day ...................4........4•...................f�+++++.................... Plan Che _ CITY OF TIGARD Mechanical Permit ^%pplication Recd By k-— 13125 SW HALL BLVD. Commercial and Residential Date Recd �3-777/ TIGARD, OR 97223 Date to P E _ (503}639-41171, x304 Date to DST � Print or Type Permittill J /i!' 1-0 5 Incomplete or ill( ;bible applications will not be accepted Called N�riy 1 of DevetopypInuPro ect Description )C 7 )G((?r j Table 1 A Mechanical Code QTY PRICE AMT Job Street AddressSuite* Al Pemut Fee -0- -0- 1000 Address ',' ScJ / tL Bidgir ClyiSlate Zip 1 ) Furnace to 100,000 BTU 6.00 / /'cf to J2 q including ducts&vents _ N e tot name of business 2.) Furnace 100,000 BTU* %50 f 7 including duds&vents Owner _y`r-�, /gnd��so/1 g Mailing Address 3.) Floor Fumace 600 including vent C ty,State Zip Phons 4 i Suspended,seater,wall heater 6,00 < U/ -! � or ffoor mounted heate• N (or name of business) 5.) Vent not included in appliance permit 300 Occupant Mailing Address 6) Boller cr comp,heat pump,air Gond. 6.00 to 3 HP;absorb unit to 100K BUT" CityIState Z;p Pnone 7) Boiler or comp,heat pump,air Gond 11 00 3-35 HP.absorb unit to 500K BTU-` Contractor 8.; Boiler or comp,heat pump,air cond 1500 (Pnor to L(i,, t rCL 15-30'0P absorb unit.5-1 and BTU" issuance - sling Address 9) Boiler or comp,heat pump,air cond 22.50 applicant 5, _V 9 30-50 HP;absorb unit 1-1 75md BTU" must provide alt cityi tote ' Zip Phone 10.) Boiler or comp,heat pump,air cond 3750 contractor / O _ >50 HP,absorb unit 1 75 mil BTU" license Or Const.Con Board t c a Exp.Date 11.) Air handling unit to 10 000 CFM 450 information for CUTCOTay sness Tq��°J Metros Exp.Date 12.) Air handling unit 10,000 CFM 7 10 databasel (7,`J y� Architect NaR1e 13) Non-portable evaporate cooler 4 50 or Mating Address 14.) Vent fan connected to a single dud 300 Engineer ciyistate =hone 15.) Ventilation system not included in 4 50 _ appliance permit _ Describe work New O Addition O Afteratio Repair O 16) Hood served by mechanical exhaust 4 50 to be done Residenttalafi" Non-residential O Additional 7escnption of work 17) Domestic incinerators 750 181 Commercial or industnai:ype 30 OU Incinerator Existing use of 19.) Repair units 4 50 budding or property 20) Wood stove 4 50 Proposed use of 21 ) Clothes dryer,etc. 450 budding or property 22) Other units 4 50 a c~ Type of fuel-oil O natural gas.0' LPG O electric O 23) Gas piping one to four outlets 200 r I hereby acFunowledge that I have read this application,that the 24) More than 4-per outlets(each) 50 f- information givon is correct,that I am the owner or authorized agent of .� the owner,that plans submitted are in compliance with Oregon State QTY SUBTOTAL laws. Signatu f er/Ag t Date 'SUBTOTAL r, 0, �- C 9`�_�) 5"o SURCHARGE ct Person Na Phone PLAN REVIEW 25°16 OF SUBTOTAL n TOTAL ( f L dst\mechpmt doc (rev 9 'MinimumOermit fee s 525*5°6 surcharge "Residential ASC requires site plan showing placement of unit.