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ti CITY OF TIGARD BUILDING INSPECTION DIVISION �--
ii
24-Hour Inspection Linc: 6394175 Business Phone: 639-4171
Date Requested: - / / A.M. _ P.M.__ _ MST:
t,ocation: BUR
Ten..mt:_ Suite: _Bldg: _ NEC:
Contractor: H`OT iTT— (li1Zlp/"Lf C5� Phc� �^ ' 3C�p7��6 .--� PLM: —
Owner: .2. -EVEk� /�/nnjA)01 hone: _ ca=/vw►— ELC: _
Mo Tj t,,r—A4--E ELR:
_ SIT:
BUILLAING BLDG(con't) PLUMBING ,. ECNANICA�. ELECTRICAL SITE
Site Post/Beam Post/13ea.n e--�►st/t3cam Cover/Service Sewer/Stonn
Footing Roof UndFl/Slab Rough-In Ceiling Witte Linc
Slab Framing Top 0111 ,;m, ,m, Rough-In IIG Sprinkler
Foundation Insulation Sewer Ffomc7/buct Reconnect V(,ult
Bsmt Damp Ihywall Stonn Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Rhear/Sheath Fire Spk1r/A1nt Crawl/Fowid Ih Ifeat P(unp Low Volt
Approved Approve(] �0vc( Approved Approved
Appr/Sdwlk Not Approved Not Approved ^NoT7`pproved Not App oved Not Approved 1
FINAL FINAL. FINAL FINAL FINAL
CI(_'all for rein O Reinspection fee of S_ required before next inspection 173 Unable to inspect
Inspector -----�.�.._ late:_- � Z r Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: /' _ / `Af_ _
P.M. MST:
location: /n93 SLC/ y/� �2/ /� BUR
"I'cnant: 1Z=4/Fs z </�yl_i�_ Suite: __Bldg: �_
Contractor:_ Phone: _ Z� 3a PLM:
0wner: Phone: ELC:
ELK:
_ _ SIT:
BUILDING BLDG(con't) PLUMBING L ELECTRICAL SITE
Site Post/Beam Post/Bcam Posi/licam Cover/Service SewenStonn
Footing Roof UndFl/Slab Rough-In Ceiling Water line
Slab Framing Top Out (ias line Rough-In I1G Sprinkler
Foundation Insulation newer Ilcxx]lhtct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Ihain A/C Il(;Slab
Sheat/Sheath Fire Spklr/Alm Crawl/Found I)r I leaf Pump I ow Volt
Approved Approved 42i xovcd Approved Approved
Appr/Sdwlk Not Approved Not Approved Nod Approved Not Approved Not Approved
FINAL FINAL ,
A FINAL FINAL
M Call for reinspec ' O Reinspection fee of Srequired before next inspection C3 Unable to inspect
Inspector: __ Date: �,z __ Page of_
CITY OF' TIGARD MECHANRMITICAL
PF
DEVELOPMENT SERVICES PERMIT #t. . . . . . . : MEC97-0469
13125 SW Hall Blvd., Tigard,OR 97223 (503)F39.4171 DATE ISSUED: ll /C-6/97
PqRCEL: 2S111CC—1-3800
SITE ADDRESS. . . : 10235 SW HIGHLAND DR
SUBDIVISION. . . . : SUMMERFIELD NO. 4 ZONING: R I PI)
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . . : 189 JURISDICTTON: TTG
CL-A,--'.S OF WORK. . :ADD FLOOR FURN. . . . : 0 EYAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . - 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R,3 VENTS W/o APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL 0-3 HP. . . . 0 DOMES. J1\1CJN: 0
3-15 HP. . . . 0 rOMML. TrqCIN-. 0
MAX INPUT: 0 BTU 15-30 HP. . . . 0 REPHIR UNITS: 0
F IRE. DAMPERS?. . : 30-50 HP. . . . 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . 0 C1...0 DRYERS. . - 0
NO. OF AIR HANDLING UNITS OTHER UNITS. : 0
L71.
FURN ( IviliK LTL': 0 1�11LA .0
Ci-M: 0 GAS OUTLETS. : I
FURN ) =100K BTU: 0 > 100-010 c,fm: 0
Re.mar-k s : Add gas piping for gas insert in fireplace to an existing single family
dwelling.
Owner: FEES ----__—_—.-____-..
STEPHEN RAINOLDI type amni.int by date recpt
10P35 SW HIGHLAND DR PRMT $ 25. 00 GED 11/26/97 97-301275
TIGARD OR 97224 5PCI $ 1. 25 GEO 11/26/97 97--301275
Phone #.- 620-3876
(-:ontr-ac-tor-:
HOT c3r,nT FIREPLACE 9, PATIO
11525 SW CANYON RD
$ 26. 25 TOTAL
BEAVERTON OR 97005
Fah one #: 903-626-4651--,.,
Reg #. . - 000717 ---- -- REQUIRED INSPELTIONS
This permit is issued subject to the regulations contained in the Gas Line Itisp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mi se. Inspection
applicable laws. All work will by done in accotAanre with Final Inspection
approved plans. This permit will expir, if work is not started ..........
within 180 days of issuance, or if work is suspended for vori
than 180 days. ATTENTION: Oregon law requires you to follow roles
adopted by the Oregon Utility Notification Center. Those rules ars
apt forth in OAR 952-801-0010 through OAR You may
obtain copies of these rules or direct questions to OLIC by calling
15831246-9187.
Tss._ie 13y :
r-ler,mittee Signati.ir-e
. ................++4............4.........4•.......................................4-+4+
Call 639-4175 by 7-CA0 p. m. for- inspections needed the next bl-isiness day
++++++++4•................++++++++4...........V+-.........4+++4....................4
Plan Check#
CITY OF TIGARD Mechanical Permit Application Rec'd By
3125 .;,W HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P E _
(503) 639-4171, X304 Date to DST
Prirt or Type Permit# y-`t
Called
Incomplete or illegible applications will not be accepted
�I Name of Development/Project Description
JTable to Mechanical Code CITY PRICE AMT
Job Street Address Sutter A) Permit Fee 0 -0- 10.00
Address /•�� �idl bPlA'j 4, 1
_
Bldg# Cltyfslate Zip ^ 1.) Furnace to 100,000 BTU _600
7/6"'ro) ;z� including ducts&vents _
Name for name of busin�iejld�) 2.) Furnace 100,000 BTU+ 7.50
Owner �; C
� l ' .J�/T/,11�7f oo including ducts&vents
Melling Addle'} 3.) Floor Fumace 6.00
/�,'%�S S i�) /1,< /ff7t�i' �l� including vent
City/State ZIP
Phonal ,,( � 4) Suspended heater,wall heater 6 00
�U / or floor mounted heater
Name for name of business, 5.) Vent not included in appliance permit 3.00
Occupant flailing Address } i 6) Boiler or comp,heat pump,air cond. 6.00
to 3 HP;absorb unit to t 00K BUT-
Ci y'SlateZlp Phone 7) Boiler or comp,heat pump,air Gond. 11.00
__ _3-15 HP;absorb unit to 500K BTU" _
Contractor Name -� B.) Boiler or comp,heat pump,air cond. 15.00
15-30 HP;absorb und.5-1 mil BTU"'
Prior to permit Mailing Addrert 9) Boiler or comp,heat pump,air Gond. 22.50
issuance,a copy _ 30-50 HP;absorb unit 1-1.75mil BTU"_
of all licenses Cny/state Zip Phone 10) Boiler or comp,heat pump,air cond. 37.50
are required H >50 HP;absorb unit 1.75 mil BTU" _
expired in COT OreM Ccnat.Cont.Board I-ic k' Exp 0 to 11.) Air handling unit to 10,000 CFM 4.50
database
Architect Name 1_.) Non-portable evaporate cooler 4.50
or Mailing Address _ 14.) Vent fan connected to a single duct 3.00
Engineer City/Slate- Zip Phonr. 15.) Ventilation system not included in 4 50
___ appliance permit _
Describe work New C Addition O Afteration'Q Repair O 16.) Hood served by mechanical exhaust 4.50
to be done_ Residential)b Non-residential O_
Additional Description of work; - 17) Domestic incinerators 7.50
►�/�}-1 //��/ /, r - J) [/ t <� 18.) Cummerraal or industrial type 30 GJ
Incinerator
Existing use of 19) Repair units 450
building or property I`�� �y/_L)L
20.) Wood stove 450
Proposed use of / 21 ) Clothes dryer,et%. 4.50
building or property
22.) Other units 4,50
Type of fuel-oil O natural ga -- LPG O electric O 23.) Gas piping one to four outlets / 2.00
I hereby acknowledge that I have read this application,that the 24) More than 4-per outlets(each) A .50
lnfornation given is coriect.that I am the owner or authorized agent of _
the owner,that plans submitted are to ompliance with Oregon State - - QTY.SLi'3TOTAL
laws
Signature of OwneriAgent / Date / - *SUBTOTAL
5%SURCHARGE
I _1 7
Contact i'vrson Name Phone PIAN RLVIEW 25%OF SUBTOTAL
�- TOTAL �f
iAmechpmt doc (rev 9 'Minimum permit fee is$25+5%surcharge
-Residential A1C requires site plan showing placement of unit.