14275 SW 125TH AVENUE I
ADDRESS:
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CI fY OF TIGARD BUILDING INSPECTION DIVISION �.
24- 1-,,1 Inspection Line: 6394175 Business Phone: 6394171 L
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Date Requested: r'd -61 - '771A A.M. I'M� ST.
Location: 757 �-�'�' (.//l,P �— BUP:
Tenant: Suite: Bldg: MEC: 3
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Contractor:, _ _Phone: GU _3 �(� _ PLM:
(hsncr: T91 T�
� PLYPhone: Jr < D - 3 95 � ELC:�.
0/111- TD Grp-s co kyC S IO&J-4)6 h(:47-Srr:
BUILDING BLDG(con't) P;.UMBING k:__MECF'�ANiCAL , ELECTRICAL SITE
Site Post/Beam Po-t/Bcam Post/B.am Cover/Service Sewer/Storm
Footing Roof UndFI/Slal Royjji�dn Ceiling Water Line
Slab Framing Top OutGas Lin Rough-In lJG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm ,uma,;� Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Dr I lcat ' Low Volt
Approved Approved Approvcd Approved Approved
Appr/Sdwlk Not Approved Not Approval 4bf iT proved Not Approved Not Approved
FINAL FINAL "1�'�NK1, FINAL FINAL
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2, ('i.�.�Y_� I - CFI'tr�'n� 0
'Ilk a v�bt O��M. YYIIt��T t s Mfr 111 ✓ �)DYtS
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D Cell for reinspection 0 Reinspection fee of S required before next inspection O Unable to inspect
Inspector:?1,1�..� Date:, 0 Page of
' CITY OF TMECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 5W Lyall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT #. . . . . . .: MEC97-0343
DATE ISSUED: 09 15/97
PARCEL: 25109AA-00600
SITE ADDRESS. . . : 14275 SW 125TH AVE
SUBDIVISION. . . . : ZONING: R-4. 5
BLOCK. . . . . . . LOT. . JURISDICTION: TIG
CLASS OF WL,(K. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . : R3 VENTS W/O APP1-: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES--.----------- 0-3 HP. . . . : 0 DOMES. I NC I N: 0
:GAS 3--15 HP. . . . . 0 CrIMMi_. I NC I N: 0
MAX INPUT: 0 BTU 15--30 HP. . . . : 0 Rt-PAIR UNITS: 0
FIRE DAMPERS". . : 30-50 HPI. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS----------- AIR HAN')L I NG UNITS I7THE R UNITS. : 0
FURN < 100K BTU: 1 <= 10000 cfm : 0 GAS OUTLETS. : 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Conversion of oil to gas fur.
Owner: - --______________---_____------.---.--. ------------..______ FEES ----_---------__
CORT CARLSON type amount by date recpt
14275 SW 125TH F'RMT f 25. 00 DRA 09/15/97 97-299253
TIGARD OR 97224 5PCT `6 1. 25 DRA 09/15/97 97-299253
Phone #:
Contrartor: —__ ---- - - - --- -- -------- --
SOUTHWEST SHEET METAL_
10415 SW 72ND
f 26. 25 TOTAL
P=ORTLAND OR 97223
Phone #: 503-245-6284
Reg #. . 000450
-------- REQU I r ED I NSPECT I ONS --- -This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all lAher Mechanical Insp
applicable laws. All work will be done in accordance with Heating Unt Insp
approved plans. This permit will expire if work is not started Misc. Inspection
within 198 days of issuance, or if work is suspended for more Final Inspection
than 18@ days. ATTENTION: Oregon law requires you to follow rules
ct
adopted by the Oregon Utility Notification Center. Those rules are
�- set forth in OAR 952-WI-WI8 through OAR 952-d8I-8998. You lay
> obtain cepies of these rules or direct questions to OUNC by calling _-
�- (583)246-9187. _
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J Iss1-i By : �� !� --�� Permittee Signature:-
4.........4.,f-+ ..... ...............4.+++4......................................J-+++
ignature:-++++++++++ r•+; +++++ .+++++++++++++++•+++;+++++++++++++++++++++++++++++++++++++J-+++
Call 639-4175) bl,, 6:00 P. M. for inspections needed the next business day
++++++++++++++...+ +++++++++++++++++++++++t++++++++++•+++++4+++++•}+++++++++++++++++
Plan Ch
CITY OF TIGARD Mechanical Permit Application Recd B % /-w -
13-125 SW HALL BLVD. Commercial and Residential Date Recd
Date to P.E.
TIGARD, Oil 97223 Date to DST
(503) 639-4171, x304 Permd#
Print or Type Called
_ Incomplete or illegible applications will not be accepted
Name of DeveiopmanVPro)W Description
Table 1A Mechanical Code CITY PRICE AMT
Job Sueet A oressuites A) Permit Fee 0 10.00
Address } -
Biagi Cdyisinte zip 1.) Furnace to 100,000 BTU 600� `�I'1
includingduds&verts b
N e�lfor n e of tyµ as) 2.) Furnace 100,000 BTU+ 7.50 �
Owner `_ .---4r/ inctudinq duds 8 vents
Mailing Agrureser/ 3.) Floor Furnace 6.00
' - �C(J including vent
C to Zip Phone 4) Suspende'leater,wall heater 6.00
�iio� !� X712 S or floor r rted heater _
N for name of business) 5.) Vent not included in appliance permit 3,00
Occupant Mailing Add ;.) Boiler or comp,heat pump,air cond. 6.00
to 3 HP;absorb unit to 100K BUT"
Cityrstate ZJp Phone '.r Boiler or comp,heat pump,air cond. 11 R
__ 3-15 HP;absorb unit to 500K BTU"
Contractor N C _ 8.) Boiler or comp,heat pump,air Gond. 1500
(Prior to �-� CCT- J �e,!� -Q 15-30 HP,absorb und.5-1 and BTU"
issuance Maiing Addres 9.) Boiler or comp,heal purnp,air cond. 22.50 K
applicant 9,C) -/ 30-50 HP;absorb unit 1-1.75md BTU"
must provide all Zip Phone 10.) Boder or comp,heat pump,air cord. 37 50
Z
contractor "44 ! _3 2p/ 50 HP;absorb unit 1 75 mil BTU"
licen3e UrJ9cn Const.Cont Board be M Exp.Dole 11.) Air handling unit to 10,000 CFM 4.50
infonnaticio if ar/
exoired in _;;k
COT _WT BUes Tax or Metro a 12.) Air handling unit 10,000 CFM 750
database). /I 1
Architect Name 13.) Non-portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single dud 3.00
Engineer biStale zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Descnbe work New O Addition O Alteration O Repair O 18.) Hood served by mechanical exhaust 4.50
to be done Res0ential O Non-residential O -
Additional Description of work 17.) Domestic incinerators 7.50
18.) Commercial or industrial type - 30.00
L/ !ll���QQQCYI� Incinerator
Existing use of � 19) Repair units 4.50
building or property G
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer,etc. 450
building or prom-ty _ vJ
22) Other units 4.50
Type of fuel-oil O natural ga LPG O elecanc O 23) Gas piping one to four outlets ( 2.00 1-i
I hereby acknowledge that I have read this application,that the 24) More than 4-per outlets(each) 50
information given is correct,that I am the owner or authorized agent of I _
the owner,that plans submitted are in compliance with Oregon State OTY SUBTOTAL
laws - -- _
Signatu of Owner/Agent Date 'SUBTOTAL r r D
5416 SURCHARGE
Co It Person e /Phon PLAN REVIB4 25%OF SUBTOTAL
e/4)
i kistVnechpmt doc (rev 9 'Minimum permit fee is S25+5%surcharge
-Residential A/C requires site plan showing placement of unit.