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11756 SW 129TH PLACE I �J1 �l V7 G� F.J IU r t" i 11756 SW 129th F.1 PITY OF TIGARD BUILDING INSPECTION DIVISION 24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST --- -- BLIP Date Requested_ — Y—&;10 AM_ _PM _-- BLD Location / / 4:;-& ' —r--- — �� _..�� ' _�_— Suite — - MEL: ']� 64� ��� Contact Person Ph _ _ _ PLM Contractor Ph SWR - BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access* �- FoundaiionJJ FFIS /;� Ftg drain _6 � — Crawl ur-',n Inspection Notes: SGN Slab �i T Post&Ream --- - - -- Ext Sheath/Shear Int Sheath/Shear - - Framing Insulation �/ Drywall Nailing L'!, I�/ '°a4'to I !/�:dvt L� ��ClC �1'ee_ (4: 23 - 1/1. Firewall Fire Sprinkler Fire Alarm � � � �,� `ZZ� ?�C•t� G Susp'd Ceiling rA / l IIA Root - Misc Final (' PASS FART- FAIII PLUMBING Post& b:.-:gym -- Under Slab Top Out _ - Water Service , a1� �ZLj Sanitary Sewer ---- Rain Drains T_�"' 5.1� �• i G, �yC- �!L11�� � Final -- PASS PART FAii.. ASL Post& Beam - -- - - - ----- ------ - Rou h In Smoke Damper- _ _ -----_ 1 ` PART FAIL ELECTRICALService Rough Rough In -- UG/Slab Low Voltage Fire Alarm Final ----- - _ _ PAS'� PART FAIL __- 817E Backfill/Grading ---- ------ Sanitary Sewer Storm Drain )Reinspection fee of$ required before next inspection Pay at City Hall, 13125 SW Hall Blvd CatchPlease call for reinspection RE Fire Supply Line I ) p Unable to ';,pect-no access ADA Approach/Sider alk Date "V Inspector G4 Other _-- _--- p — - _Ext Final PASS PART FAIL 00 NOT REMOVE this Inspectlon record from the job site. CITY GF 'f IGA RD BUILDING INSPECTION DIVISION 41ST 24-Hour Inspection Uiiie: 639-4175 husin3, s Line: 639-4171 ( -- �,��!� BOF' _ [late Requested_ 3 � __AM-- PM BLD Location I V-7 G 'Z 9 , �. Suite Contact Person Y�(�� Q��)� Q. Ph ',:_' PLM Cor;tactor — Ph SWR BUILDING Tenant/Owners- �t �g� Retaining Wall � ELF _ Footing ACce:;s: Foundation FPS — Ftg Drain SIGN Crawl Drain Inspection Notes: Slab —.-_._. _— _ SIT Post&Eeam Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Neilinq --- --- -- ------- _. - Firewall Fire Sprinkler - Fbe Alarm Susp'd Ceiling - - -- --- Roof Misc. Final PASS PART FAIL - PLUMBING Post&Beam _— --- -—- -------� _/ ---- --- - Under Slab Top Out Water Service Sanitary Sewer Rain Drains —.-- - - - - --- ------- - -- - --- - — Cinal PASS PART FAIT Post& Beam -- - ---- ---- ---- ----- --- _ _- - — — — Rough In Gas Line --- ----- _._.- - -- - ----- --- -- -------- S oke Dampers S PAR" FAIL ,arVICe Rough In — - UG/Slab - -- -- -- ----------._._-.. ---------- Low Voltage FireAlarm - --------___- �_ ---- ... -- ---- ---------- -- PART FAIL _-_ __ __-.-- - - ----- ----_ tliik SITE Backfill/Grading -�-----'"-`-- - —�--• Sanitary Sewer Storm Drain ( ]Reinspection fee of$-- _required before next inspection Pay at City Hall, 13125 gW Hall Blvd Catch Basin Fire Supply Line ( ] Please call for reinspection RF: — I ) Unable to rnspfct-no access ADA F pproach/Sidewalk Date � � —Inspector - rr' r Ext ,1,,Iler - —___ �_ Final PASS PART FAIL_ DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639-4175 (Business Line: 639-4171 — - 13UP - -__---Date Requested 3� - AM-- PM BLD j ��J 12- Suite MEC %7�� -000 '� Location --�- _- Contact Person (YI Ph _ -_ - PLM Contractor Ph --_ __.-.. SWR ---- -- BI Lir DING — Tenant/Owner _ ---, - ELC Retaining weii ELIR ____ _ _• Footing Access - Foundation FPS _-- Ftg Drain SGN Cra%vl Drain Inspection Notes: Slab ------- �XX� � -C"`��.- - - - SIT Post&Beam .:2 /,, - ----- --- - Ext Sheath/Shear ---- --- - Int Sheath/Shear Framing -_- --- -- - - - - Insulation Drywall Nailing _ A& _o�`q /�v,4 L,4 b L�� �7�'=�i�= c �7 CC v ='� Firewall Fire Sprinkler 1"i�e,�s�`�_ `�� S'clj��!i�v L� i..l,',•����1,J _- Fire Alarm Susp'd Ceiling - Roof Misc:_- -- --— - - -------- Final PASS PART FAIL - -- --- - - - PLUMBING Post& Beam --� -' --- - ------ Under Slab Top Out - -- Water Service ---_ ------ -- ._- --_ ——.—_ ----------__ Sanitary Sewer Rain Drains -- Final _ PASS RT FAIL CHANICA --------_------------ f'ost& Beam ---------�-- -------- ---------..-_ Rough In Gas Line --- -_- - ---------- - -- --- - - - ----- Smoke Dampers Final PASS PARf' IL ELECTRICAL Service ---__---- Rough In -- ------------------ UG/Slab --- -_ -- ----- - Low Voltage FireAlarm --- -- - -------------------.._--...------ ---- Final PASS PART FAILSITE Backfill/Grading --- — - — Sanitary Sewer Storm Drain ( [Reinspection fee of$--__--required before next inspection Pay st City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line ( J Please call for reinspection RE - [ �Unable to inspect-no access ADA Approach/Sidewalk Other Date =w_. --G' ' Inspector Ext Final PASS PART FAIL 00 NOT REMOVE' this. Inspection record from the job site. CITYOF TI GA,R Q __ MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT#: MEC2000-0003-, 13125 SW Hall Blvd.. Tigan.:, OR 97223 (50? DATE ISSUED: 2/29/00 SITE ADDRESS: 11756 SW 129TH PL j ( PARCEL: 1S133DD-01600 SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 2 BLOCK: ZONING: R-4.5 LOT:055 JURISDICTION: TIG CLASS OF WORK: OTR FLOOR FURN: TYPE OF USE: SF EVAP COOLERS: UNIT HEATERS: OCCUPA14CY GRP: R3 VENT FANS: VENTS W/O APPL: VENT SYSTEMS: FUEL TYPES STORIES: BOILERS/COMPRESSORS -_— HOODS: 0 - 3 HP: 1 DOMES. INCIN: MAX INPUT: 3 - 15 HP: COMML. INCIN: FIRE DAMPERS?: BTU 15 - 30 HP: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN >=100K BTU: <= 10000 cfm: i OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Installation of a/r,unit. Placement of a/c unit must Comply with standard setbacks. Owner: GRIFFIN, KENNETH R + ROXANNE M FEES 11756 SW 1291 H PL FPC By Date Amount Receipt — TIGARD, OR 97223 DEB ?-/29100 $4.00 00.32iC8F, DEB 2/29/00 $50.00 00-321886 Phone: To $54.00 Contractor: D + R HEATING+ AIR COND PO BOX 1292 27251 S DAVE RD CANBY, OR 97013 REQUIRED INSPECTIONS Phone: Cooling Unt Insp Reg #: I IC 84489 Final Inspection This permit is issued Subject to the regulations contained in the Tigard Municipal COL+e, State of Ore. Specialty Codes and all other applicable laws. All work will be dont in aproved plans. This permit will expire if work is not started within 180 days of issuance, Or ifaccordance witoh kis upended 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 U2-001-0080. Ybu may obtain copies of the f� Cules or direct questions to OUNC by callih45031K9189 �-Issue BY Permittee Signature: Call (503)'639-4175 by 7:00 P.M. For inspections heeded ext business day CITY OF TIGARD Mechanical Permit Application Recd y 13125 SW HALL BLVD. Commercial and Residential Date Rac,d j- -0 TIGARD, OR 97223 �,�/ Date to P.E. (503) 639-4171, x304 '(Zo 7 Date to DST Print or Type l�'� Permit#N' Incomplete or illegible applications will not be accepted c;rned If Name of Developmen'rProled Description "I Table 1A Mechanical Code City Price Amt 1 Street Address _ uitca -- A Permit Fee _ 16,00 Job / 1) Furnace to 100,000 BTU Address � including ducts 8 vents see footnote 1,2 9.65 Ido# city/State 2ip 2) Furnace 100,000 BTU+ iv -- Including ducts&vents see footnote 1,2 12.00 Name(or name of business) 3) Floor Furnace including vent see footnote 1,2 9.65 owner C ' /i 4) Suspended heater,wall heater Moiling Address or floor mounted heater see footnote 1,2 9.65 % 5 Vent not included in appliance ermit 4.75 CK/State zip Phone Check all that apply 'Boiler Heat Ai; W'd t-Z y%113 j� ijj�log For Items 6-10,see or Pump Cond city Price Amt --- -- footnotes 1,2 Com N (or nems of business) 6)<3HP;absorb unit to p�0 100K BTU _ 9.65 Occupant Mailing Address 7)3-15 HP;absorb unit 100k to 500k BTU 17.65 city/State 21p Phone 8)15-30 HP;absorb unit.5-1 mil BTU _ _ 24.15 Contractor Name 9)30-50 HP;absorb unit 1-1.75 mil BTU 35.00 10)>50HP;absorb unit Prior to permitIng Address >1 75 mil BTU _� 60.15 iisuance,a copy r/ C 11 Air handling unit to 10,000 CFM of all licenses cit Istat" zip Phone 7.00 _ are required If 0, / [1r 12)Air hanul!"q unit 10,000 CFM+ expired in COT of°�n C st.Cont.Board Lic# xp.Date _ 11.75 database Cry/ f% 4 13)Non-portable evaporato toiler Architect Name _ _ _, 7.00 14)Vent fan connected to a single duct or Mailing Address 4.75 15)Ventilation system not In:luded in appliance permit 7.00 Engineer City/statep Phone 16)Hood served by mechanical exhaust _ 7.00 .---z -t Describe work to be done: 17)Domestic incinerators 12.00 New O Repair O Replace with like kind. Yes O No O 16)Commercial or Industrial type incinerator Residential Commarcial o 48.25 19)Repair units Additional Information or description of work. Y 8.40 n�e 6 ` Tev-1/11/� 20)Wood stovelgas FP/other units/clothe dryer/etc. 7.00 NOTE: For Commercial projects only;Units over 400 lbs require 21)Gas piping one to four outlets structural gas colts. See footnote 1 3.7,5 Type of fuel: oil O natural gas LPG O electric O _ 22 More them 4- er outlet each) 75 Minimum Permit Fee_ $50.00 SUBTOTAL hereby acknowledge that I have read this application,that the information %SURCHARGE ' given Is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL the owner,that plans submitted are in compliance with Orcgon State laws _ Required for ALL commerclsl permits onl TOTAL c' J Signature of � Date Other Inspections and Fees: a 1. Inspections outside of normal business hours(mininum charge-two 016-hract Planson Name Phone hours) $50.00 per hour 1 2. Inspections for which no fee Is specifically Indicated (minimum charge-half hour) $50.00 per hour Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to 1. Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$60.00 per hour 2. Provide drawings to scale showing existinn and proposed mechanical units. _ 'State Contractor Boiler Certification required "Residential A/C requires site plan showing placement of unit 1:lrneehperm doc rev 02/4199 1 1 F i l CITYO F TI C A R D __ EL ECTRICAL PERMIT DEVELOPMENT SERVICES PERPT#: E -00084 +! DATE ISSUED: 02//29/2029/20U0 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 SITF ADDRESS: 11756.r,W 129TH PL PARCEL: 1 S 133DD-01600 SUBDIVISION: VILLAGE AF SUMMER LAKE PARK 2 ZONING: R-4.5 BLOCK: LOT : 055 .JURISDICTION: TIG Proiect Description: Residential alteration _RESIDENTIAL UNIT TEMP SRVC/FEEDERS �— MISCELLANEOUSv 1900 SF OR LESS: 0 200 amp: PUMP/IRRIGATIOW EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp• SIGNAL/PANEL: MANF HM/ SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W/SERVICE OR FEEDER: 1 PER INSPECTION__ 20 r - 400 amp: 1st W/O SRVC Or FDR: PER HOUR: 401 - 600 anip- EA ADD'I- BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp/volt: >=4 RES iiNITS: > 600 VOLT NOMINAL: Reconvert only. _ SVC/FDR >=225,AMPS: CLASS AREArSPEC OCC: Owner: `contractor: GRIFFIN, KENNETH R + ROX.ANNE M ABC ELECTRIC CORPORATION 11756 SW 129TH PL 135 NE 9TH TIGARD, OR 97223 PORTLAND, OR 97232 hone: Phone: 233-7551 Reg#: LIC 000002 SUP 12415 PLM "SEE" ELE 26-2C _FEES --� Required Inspections Type By Date Amount Receipt r Elect'I Service PRMT BONv 02/29/200C $69.60 00-321881 I Elect'I Final 5PCT BON 02/29/200C _ $5.57 00-321081 I Total $75.17 I ORIGINAL This Permit is is%uad subject to the regulations contained in the Tgaid Municipal Code,State of OR Specialty Codes and all other applicable la pus All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 day%of issuance,or if work is suspended for more than 180 days. ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Uti:ity Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503) 246-1987. PERMITTEE'S SIGNATURE �1 N, �. ISSUED BY: 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 SUVR. ELEC'N: DATE:-- _ LICENSE NO: Call 639.4175 by 7:00pm for an Inspection the next business day i Foto-29-00 09 : 10A P . 02 CITY OF TIGARD Electrical Permit Application i`IanCheck# _ 13125 SW H,4Lt, BLVD. Recd By Z�09 j F/4 V TIGARD OR 97223 nate Recd Date to P.F- _ _ Phone (503)639-4171 x304 Date!to DST inspection (503)639-4175 Print of Type Permd N Fax (503) 598-1960 Incomplete or Illegible will not be accepted called J. Job Address, 4. Complete Fee Schedule H,low: Name of Development __ -- Number of Inspections per permit allowed Name(or name of business) :L Service lncludod: Items Cost Sum Address� _u�/�.�� �_ — aa. Residential•per unit Glty/State/Zip_ r /'��)- 1000 sa ft nr INss $ 117 75 — 4 �L - � — Each Additional 500 sq,f1.or U portion therouf S 213.75 _ 1 Commercial ElResidentialUmiled Energy S 00.00 Fnch Manurd I Ionia or Mud ular 2a, Contractor installation only: Uwurimq service or Feeder $ 72 75 (Prior to permit issuance.,applicant_n rnust provide contractor license 4b.Services or Feeders informnuon for GOT data barn) Installation,aaurrlrwr or nelorallnn _ Elel'incal Contractor r 200 anfpa of leas _ $ t$4.2s 2 Add _ � 2M ampa to 400 arnpa � $ 85.50 � � 2 20 t r.mps to 1300 amps —_ $ 12R so ----- City _State_ Zip 9­7232 601 amps to 1000 amps — S 192 SU — Phone No _ �1 _—_ Over 1000 amps or volts f 3h! is 2 Job No /%� —..----- -- Hucunrrrct only _. $ 53 50 _....�—- 2 Else Cont Ucp No _ �1_ Exp.Date . . 4c.Temporary Services or feeders OR State CCB Reg r _�'�. Exp Dat , IrsImIlatmn alterahun or rouwtiuri COT Business Tax o M ,to No Q Exp 111E 200 amps ur lyse; b 5350 / 201 amps to 400 annpu — ); 50 25 �- 1 401 amps to 000 amps 1u0 00 2 Signature of S� � � Ova(600 arnpu to 1000 votes. -� License No r Ex to soo^b^above. jr 4d.Branca Circuits Phone No �-u-•-�� -- NPw,Alteration or extenslerl pun panel A)The too for brarrcii(jrcults 2b. For owner installation . with purchase nrservice or feeder tee. Print Owner's Name __-- Each branch ur�,wl 1_ $ a 35 Address u) I Ire lee Inr hrAnrh cirunts — without purchaso of servmce City ----_ State--_Zip — or feeder fee. Phone NO —_ — First branch circuil $ 97 Sn Each nddltional branoi circuli _— S 5 35 _ The Installation is beitlg made on property I own which Is not 4e.Miscellaneous Inlended fur sale lease or rent (Service or feedur nut InrJudAd) Lade pump of irrigation circle S 42 is Uwners Signature _- - ---_. -- -- - Each sign or outline hptthny --- $ 4275 -" Slgnol rarcud(s)of a limned ern-fgy 3. Plan W-view section (if required):" panel,ellerAlion orexit)its wu 111U0 Miner Labels(1U) = 10000.00 Please check appropriate Ilern and enter fee in sactlon 68 41.Each additional inspaction over - 4 ur n mer rngrdp-nhnl units in one structure the allowable In any of thu above — Servire end feeder 225 amps or more Per Ins cchun _ 50 no S per Iwo S haIa --- yvnua — It,Plant f 511 00 ____Clae,ihcd,n:�ur shuuiure rnnlaming�perinl n,.�.n.roau�v a5 - -- —' -- dosrnhed in N L C Ulnmplcn 5 5. Fees: go.Fnter Wtal ul auuve Iger. Submit 2 sola of plans with application where any of tho above apply 139 SurchArne If 011 x tntul Not roduirud for temporary const $nict(on services. Subtotal $ - pT(CI: Sb. Ender 25%of Inns Be jut --' ('IAn Review II re air (Svc Ji S Pi:RMiTS SECOMr-vUIU IF WORK On CONSTHUC I ION AUTHORIZ6U Subtotal $ IS NU I COMMENCED WITHIN 160 DAYS On Ir CONST MUC:TION On WORK IS S USPENDFn nR ARANDONLU FOR A PFRIOD o1 100 nAYS ❑ Trutt Acceunl M�� At v.N r TIME AFI Llt WU11K r:;cnMMENCLU notal balance Due i I i. I ,nu cI,•,air Ire, --- -- MECHANICAL PERMIT CITY O F TIGARD DEVELOPMENT SERVICES PERMIT#: MFC2000 0036,0 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 09/08/2000 PARCEL: 1 S 133DD-01600 SITE ADDRESS: 11756 SW 129TH FL SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 2 ZONING: R-4.5 BLOCK. LOT: 05.5 JURISLICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP rOOLEPS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS WiO APPL: VENT SYC `=MS: STORIES: BOILERS/COMPRESSORS _ HOODS: _ FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG __ 3 - 15 HP: COMML. INCIN: MAX INPUT: CITU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS'?: 30 - 50 HP- WOODSTOVEE: GAS PRESSURE: 50 + HP: CLO DRYERS: F''r�N < 100K BTU: AIR HANDLING_ UNITS FURN >=100K BTU- T <= 10000 cfm: OTHER UNITS: GAS OUTLETS: 1 > 10000 cfm: Remarks: Installation of gas piping. ON nor: _ — FEES-- GRIFFIN, EES _GRIFFIN, KENNETH R + .OXANNE M Type By Date Amount Receipt 11756 SW 129TH PL PRMT CTR 09/08/20( $72.50 2720000000 TIGARD OR 97223 5PCT CTR 09/08/20( $5.80 272.000000C Phone: Total $78.30 Contractor: GEORGE MORLAN PLUMBING 9,306 SW TIGARD (CCB EXP 6/2002) REQUIRED INSPECTIONS _ TIGt R1), OR 97223 Gas Line Insp Phone:503-624-6895 Final Inspectian Reg #:LIC 00002734 PLM 26-60p This permit is issued subject to the regulations contained in the Tigard Municipal 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 more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in ihc- Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 -0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC b� calling (503)246-9189. Issue By: ` I Permittee Signature- - � I Call (503) 639 4175 by 7:00 P.M. for Inspections needed the next business day 1 C,11Y OF TIGARD Mechanical Permit. Application Rec'dBy 131''S Soh' HALL. BLVD. COInmercial and Residential DateRec'd 9 I iGARD, OR 97223 01 Date toP.E, (503; 639-4171, x304 Print or Type Date to DST �lcomplete or illegible applications will not be accepted Cal Permit # Q -Q0360 oo Name of OevelopmenVPro)ed Description /'_ ^ Table to Mechanical Code --Y Qty Price Total \�1 suns r 1) Fumece to 100,000 BTU Street Address v Jots Including ducts&vents 14.00 Address I ! t 2) Furnace 100.000 BTU+ oldgaC ylState zip Includingducts&vents 17.40 I- 8 ( ( � 3) Floor Fumace — Name(or n+rme of busines8 — including vent 1 14.00 5 � — 4) Suspended heater,wall heater Owner or floor mountodheater 14,00 Melling Address 5) Vent not included in appliance permit --4680 CAy/Stele �-� —t1p Phony --- 0 Repair units 12.15 Check all that apply 'Boiler Heat Air — — Nam•(or name of business) For items 7.10,see or Pump Cond city Price Total footnotes 1,2 Com _ Me'Ing Address 7)<3HP;absorb unit to Occupant t00KBTU _ 14.00 8)3-15 HP;absorb unit CNylSide Zip Phone 100k to 500k BTU 25.60 _ 9)15.30 HP;absorb Contractor N■mc unit.5-1 trill BTU 35.00 1n)30-50 HP;absorb Prior to permit sans Address unit 1-1.75 mil BTU 52.20 Issuance,a ___� 11)>50HP;absorb unit>1.75 mil BTU 81.20 ceFy 12)Air handling unit to 10,000 CFM of ail licenses gala zl Phone �, o 10.00 ate required If (� expired in COT orcgon oust.Conr--.11 Lica Esp.nate 13)Alt handling unit 10,0010 CFM+ database 17.20 Architect Name 14)Non evaporate cooler 10.00 . -- 15)Vent fan connected to a single duct Or MailingAddrnu 6.60 16)Ventilation system not included in EncJ►neer cny/sut• — zip Phone a plianw,permit 10.00 _ 17)Hood served by mechanical exhaust ___ 10.00 Describe work to be done 18)Uomestic incinerators 17.40 New O Repair O Reuiace with like kind. Yes 0 No O 19)Commercial or Industrial type Incinerator Residential• Commerr:;al O Modification O 89,95 Additional Information or descrlpd9n of world: I 20)Other units,Including wood stoves 10.00 NOTe: For Commercial projects only;Units over 400 lbs21)Gas piping one to four outlets.,located on the _15.40 roof,require structural talcs,prepared b licensed englnoer. _ 22)More(hen 4-per outlet(oath) Type cf fuel• oil 0 natural gas O LPG O electric O 1.00 — — Minimum Permit Fee .6. 7,ya SUBTOTAL ,50 1 hereby acknowledge that I have read this application,that the -- - 896 SURCFIAROEAm Information given Is correct,that 10m the cwner or authorized agent of --- PIAN RfVICW 2596 OF SUBTOTAL the owner,that plans submitted are In compliance with Oregon State Requlred for ALL commercial permits only laws. -- Signature o1 Owner/Agent Date TOTAL /' t Other Inspections and roes:1 Insped ons outside of nomml business hours(minimum charge-Mro hours) Contact Pe ame Phone S12.S0 per hour II 1 2 Inspections for which no fee is soedfically Indicated (minimum charge holt hour) [Y I I 1 r I h"��c_ — >;72 60 per hour 3 Additional plan review required by changes,additions or revisions to plans(minimum notrnteeoremmeretal Orolsrf+nnl dsryecn 1. Provide fulls emetic of existing and p,-posed gas line and pressure. red hours ftZ.So per bout •State Contrarior Boiler Cnrtlflutfon required 2. Pmvlde t;R H'nyit to scale showing existing and proposed mechanical •'Resnfenbai A1C requrra site plan showing placement of unit units. I\fists\formsvnechperm_rev doc e/29/00 7.00f31 (DIV91.1, A0 ,11,.1.13 0961 R65 £05 XVA 91:90 INA 00/90,80