10260 SW HOODVIEW DRIVE S
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10260 SW HOODV I EW DR
CITY OF ;CARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: S39.4175 Business Line: 639-4171 ---
� BUP
-_–Dale Requested- � l_ _----- —AM �---PM ELD _
Location u_=-) (: I > r�__ _e =----- Suite MEC Z076r`1 Contact Person _ Ph PLM
Contractor — __ -- Ph -- :iWR
BUILDING Tenant/Owner ELL
Retaining Wall — v — ELR
Footing Access:
Foundation FPS
Fig Drain _ `�----
Crawl Drain Inspection Note.,: SGN �`—
Slab -- ----- --- -- - 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 _--
PLUMBING
Post& Beam
Under Slab
TopOut __ _-------- -- --- . .
Water Service
Sanitary Sewer
Rain Drains
Final --`
PASS PART FAIL
Post&Beam - -
Rough In
Gas Line -
STQ a Dampers 4
in
AS' PART FAIL
ELECTRICAL - - - -
Service _
Rough In -
UG/Slab
Low Voltage
Fire/.farm I _
Final
PASS Pt,RT FAIL
SITE -
Backfill/Grading --- ------
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspectior.. Pay at City Hall, 13125 SW Hal vd
Catch Basin
Fire Supply Line [ )Please call for reinfaection RE: [ J Unable to inspRct-no act,Rs
ADA
Approach/Sidewalk
Other Date5� -C•,i Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYOF T I GA R D _- MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00147
13125 SW Hall Bled., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/7/01
PARCEL: 25111 CB-01708
SITE ADDRESS: 10260 SW -IOODVIEVV DR
SUBDIVISION: HOOD VIEW ZONING: R-3.5
BLOCK: LOT: 007 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
_ FUEL TYPES — 0 3 HP: COMES. INCIN:
GAS -- — a 15 HP: COMML INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > 100K BTU: <= 10000 cfm: OTHER TS: 1
10000 cfm: GAS OUTLETS: 1
Remarks: gas fireplace insert
Owner: --FEES - -- ---
JOE SHACK Type By Date Amount Receipt
10260 SW HOODVIE:W DR PRMT CTR ,/7/01 $72.50 272001000C
TIGARD, OR 97223 5PCT CTR 5/7/01 $5.80 272001000C
----- —
Phone: 503-224-2751 -------- Total $78.30— - --
Cnntrector:
PACIFIC GAS WORKS
PO BOX 30546
PORTLAND, OR 97294 REQUIRED INSPECTIONS
Gas Line Insp
Phone:503-317-5573 Mechanical Insp
Reg M LiC 136391 Final Inspection
This permit is issued subject to the regulations con' '-led in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set fo th in OAR 952-001-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OU�NQ callin )246.9189.
Issue By: ,_�- Permittee Siynatwe � �'''� --2--
Call ( 03) 639-4175 by 7:00 P.M. for inspections ded the next business day
mechanical Permit App]imfion
\
City of Tigard — Dale received: n Permit no
'-
ProjecVapr.l.no.: Expiredate:
City ofTibard Address: 13125 SW Hall Blvd,Tigard,OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: . - Building permitno.:
:LUJ
=construction
ng or accessory U Commercial/indusuial U Multi-family U Tenant improvement
U Addition/al(eration/replacement U Ocher:
Job address: f Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit. Value$
Lot: Block: Subdivision: 'See chec!:list for important application information and
P, jurisdiction's fee sthedulc for residential permit fisc.
City/county: ;• Zip: 9 9Z 2`
Description an oration of work on premises: IM 01t
Est.date of completion/inspection: 4ee(ea.) Total_I)excri Hien tlt}.
Rm.only Ites.onl)
Tem, improvement or change,of use: IIIVAC:
Is existing spare heated or conditioned"U Yes U No Air handling unit _CFM
Is ex'.sting space insulated?U Yes U No Air conditioning(site p an require )
Alteration of existing H V C system -
loi er/compressors
Business name: *, " � State boiler permit no.:
Addr;ss: -- HP Tons BTU/H
a _ ire smo a amper uct smo a e►ectors -
City: Std ZIP: y� f eat pump(sdc p an requ red)
Phon : r ax: E-mail nstal rep ace urnac unser -TFTC!
CCB Including ductwork/vent liner U Yes U No
no.:C�' Instal I/rep ace/re ocate heaters-suspended,
City/metro lic.no.: wall,or floor mounted
Name(please print): ,/moi' „�-='per �- Vent for—n �linnce other t ian furnace
e gest on:
Absorption un its _ BTII/H
Name: Sh �_- Chillers
Addr(;ss._,ee it Com rrt sors, III'
State: 7,Ir' / nr ronmenlaTeTuust anT vent at on:
Appliance vent
Pl•.one: Fax: E-mail: Dryer exhaust
o s, 'ype res, itc a azrnat --
.-- hood fire suppression system
Name: — -----
`� `1/� Exhaust fan with single duct(bath fans)
Mailing address: _ �x atist-system a artfrom heating or AC —
City: State: ZIP: ruel piping an sl ut" up to 4 outlets) -
-- — Type: LPG le NO Oil
Phone: Fax: Email Puc ii in g cachodtionaa over outlets
rocesspiping(schematic requireir)
Name: Number of outlets
Address: t erdt 4ppIIAKe or eq—ulpmenti— --^ --
l>ecorative fireplace.
City: State: ZIP: nsert-type._
Phone: fax: E-mail oo stovi/pc et stove
Applicant's si bate: -O f)Iller:
Name ( ter:
Nrtl all Jurirtli one epi crrdit c...nds,pleae call Jurisdiction for more inftrrmalion. Permit fee.....................$
U Visa LTMasterVarcl Notice:'fills permit application Minimum fee................$
Onlit card number expires if a permit is not obtained --
_._ --E'apTrce— within 190 days after it has been Plan review(at _ %) $
Name of cardhol as shown on Cuero--- accepted as complete. Slate surcharge(8%) ....$ — S . CE D
$ i TOTAL ..... . ...............$ 7�
Crdhdderiiltrtattrre Antou.t
441-4617(60WOM)
MECHANICAL PERMIT FEES t
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION FEE: Description: r Price Total
$1.00 to$5 000.00 N"limum fee$72.50 Table 1A Mechanical Code oty (Ea) Amt
$5,001.00 to$10,000.00 $12.50 for the first$5,000.00 and 1) Pomace to 100,000 BTU
$1.52 for each additional$100.00 or Including ducts&vents 14.00
fraction thereof,to and InUuding 2) Furnace 100,000 BTU+
Including ducts&vents 17.40
_ _ __ $10�ODOAO. _ -
$10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or including vent 1400 -
fraction thereof,to and including 4) Suspended heater,wall heater
$25,000.00, or floor mounted heater 14.00
$25,001.00 to$50,000.00 $379.50 for tho first$25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional$100.00 or 6.80
fraction thereof,to and Including 6) Repair units
$50000.00.
11.15
$50,001.00 and up �- $742.00 for the first$50,000.00 and Check all that apply: Boller Heat Air
$1.20 for each additional$100.00 or For items 7-11,see or Pump Cond
fraction thereof. footnotes below. comp* *"
7)<3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: _ to 100K BTU 14.00
_ 8)3-15 HP;absorb
Value Total unit 100k to 500k PTU _ 25.60 _
Description: Q Ea Amount 9)15-30 HP;absorb -
Fumace to 100,000 BTU,Including 955 unit.5-1 mil BTU 35.00
ducts&vents5
10)30-�0 HP;absorb
Furnace>100,000 BTU Including 1,170 unit 1-1.75 mil BTU 52.2U
ducts&vents 11)>50HP:absorb
Floor furnace Including vent 955 unit>1.75 mil BTU _ 87.20
Suspended heater,wall healer or 955 12)Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not Included in appllcance 445 13)Air handling unit 10,000 CFM+
crit _ 17.20 _
Repair units _ 805 _ 14)Non-portable evaporate cooler
<3 hp;absorb.unit, 955 10.00
to 100k BTU - 15)Vent fan connected to a single duct
3-15 hp;absorb.unit, 1,700 6.80
101k to 500k BTU 16)Ventilation system not Included in
15-30 hp;absorb.unit,501k to 1 2,310 appliance permit 10.00
mil.BTU 17)Hood served by mechanical exhaust
30-50 hp;absorb.unit, 3,400 10,00
1-1.75 mil.BTU 18)Domestic Incinerators
>50 hp,absorb.unit, 5,x25 17.40
>1.75 mil.BTU 19)Commercial or Industrial type Incinerator
Air handling unit to 10,000 ctm 656 89.95
Air handling unit>10,000 cfm 1,170 - 20)Other units,Including wood stoves
Non-portable evaporate cooler 856 1000
Vent fan connected to a single duct 446 21)Gas piping one to four outlets
Vent system not Included in 856 5.40
appliance hermit _ 22)More than 4-per outlet(each)
Hood serveu by mechanical exhaust 858 L-1.00
Domestic Incinerator 1.170 Minimum Permit Fee$72.50 SUBTOTAL: $
Commercial or Industrial Incinerator 4,590 _
Other unit,Including wood stoves, 656 - 8%State Surcharge $
Inserts,etc. _
Gas piping 1-4 outlets 360 _ 25%Plan Review Fee(of subtotal) $
Each additional outlet _ 63 Required for ALL commercial permits only
TOTAL COMMERCIAL $ TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION:��- ___)
_Other Inspections and Fees:
1 Inspections outside of normal business hours(minimum charge-two hours)
$72 50 per hour
2 Inspections for which no fee Is specifically indicated (minimum charge-hall hour)
$72.50 per hour
3 Additional plan review required by changes,additions or revisions to plans(minimum
charge-one-half hour)$72 50 per hour
*State Contractor Boller Certification required for units 3,200k BTU.
"Residential A/C requires site plan showing placement of unit.
i:\dsts\forms\mech-fees.doc 10/11/00
l'I f OF T I GA R D ELECTRICAL PERMIT
PERMIT#: ELC2004-00185
DEVELOPMENT SERVICES DATE ISSUED: 4/12/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111CB-01708
SITE ADDRESS: 10260 SW HOODVIEW DR
SUBDIVISION: HOOD VIEW ZONING: R-3.5
BLOCK: LOT : 00/ JURISDICTION: TIG
Project Description: (2)branch circuits for furnace&a/c.
Job No.J19215
F___ RESIDENTIAL UNIT A TEMP SRVC/FEEDERSMISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: iPUMPhRRIGATION:
EACH ADD'L 500SF: 201 - 400 arnp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF FIM/SVC/ FDR: 6n1+amps - 1000 volts: MINOR LABEL (10):
SER\/ICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC:OR FDR 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: _ PLfW_REVIEW SECTION
1000+ amp/volt >-4 RES UNITS: >600 VOLT NOMINAL: T
Reconnect only: SVC/FDR—225 AMPS: CLASS AREA/SPEC;C•CC-
Owner: Contractor:
JOSEPH SKACH WEST SIDE ELECTRIC CO INC
10260 SW HOODVIEW DR 1834 SE 8TH AVE
TIGARD,OR 97224 PORTLAND, OR 97214
Phone: 503-598-9685 Phone: 231-1548
Reg #: LIC 13306
— st'I' _'('0S
_ FEES t
Description —� Date Amou it Required Inspections
(ELPRN1 ) GLC'Permit i I' .1.004 $53.50
ITAXj 8°, Slate Surcharge •1 !' 1(104 $4.28 Rough-in
Elect'I Final
Total $57.78
Tois Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR 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 by the Oregon Utility Notification Center Those
rules are 952-001-0010 through OAR 952-001-0100 You may obtain copies of these rules or dFect questions to OUNC r' (503)
2464 6or 1-800-332-23
Issu d By: c Permit Signature: �_t_�,
_ — 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 INSTA
7ALATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: ----- ---------- —�: –.._
Call 639-4175 by 7:00pm for an inspection the next business day
Electrical Permit App►.' -tion FOOFFi
+
uw•drvud
City of Tigard
and
1.1125 SW I(all Illvd.,'11pard,Olt 97221 Plan I(OVIOw _
I'hunc: 50.4.639.4171 Fax: 30.1.59%.14(1[) PoicAly,
ttllwrPurnm:
Iowlll:o4m Line: 503,639,417S Rifts neady/tly: — ® tiav I'a{pr 2 Pur
Inlcim,t. w,vw.c1.iIpi4I,ur,lrtl NulllicalMcrlad. _/��-..- -K1,1114 nrtnist lnlornlalion
TVPF, OP WORK PIAN RF.VIFW
❑N:w cunslrudion Addition/altcrntion/replacement Pluisc check,Ill that apply' —
❑tir:rvioe rive 7;.9 uruptl,eotnut'I El larartlous Irrculiou
C)elnolition ❑Other: ❑'crvive ovrr 120 angel w1i,ie, ❑1tuildol;river 10.000 try.ri.,
CA'1 ECiOKY OF (N)V 1'RUCTION or I-:uu1 2-family dwulhngs H ur more new remidential
1-and 2-Cnnily dwcllmi, LI C ornmerciol/indtimrial Q ACccssory building ❑Synlum over 00 violin nominal unite iu gnu wtructure
CJlluihlig.ovl•r dnrce dlurluw ❑feeders,4M(imp-4 ur rrNrry
❑ Multi-funnily ❑Muslcr builder rf culicr: ❑Occllpanl lona we, 49 l,cloons ❑Mannlholurl:rl alrm hurt or
Jf)u 51'rF; INFORMATION AND LOCATION ❑I•,(rewlightinp,plan RV park
Joh no.: \\11 Joh tale uddreb'6; lf� C
❑Ileallh-tan facility Olhrr:
�Z�__ . .. '•v 7 60 .1 l . _. 0 V/ rJ � • tinbmil L nets al'plann with any III'the above.
City/Suc/%Ip: __V a_ Y 6jo 7 z.7Lf 111u above are out applicable Io temporary conxtntcunn service.
Suilc/bld�.hgtl.nu.: ,— Projcct nanic: C - Loy. I Pt,. I Paul "1 ••
Crosti slrt-AW(lim-lions to jab site; New retlidenlial single-or multi-fnmlly dwelling unit,
includes attached garuge.
_ I AM wq,ft•(or lean _ _ 14.1,15 4_
tiuhrlivixiun: Lel 112' lis.adil'I 500 q.Il.or portion 33,40 1
_. _.. . ._
- -
'T'ax map/parcal no.: I.Imnrul energy,resrdcnunl 75,00
_--- . _..._... I.hnncd rncrFy,nrur-n:aidl:nliul 7S,INl E
DRSCRIMON OP WORK lurch minwilldo cd uh mrxlulur _
Q� Y dwcllm�til:rvluv and/or fi-Mvt Ht rN) Z..
f \ l-N_r .t rr �__�.__. ___._. .1ierviccw or I'ctdcrw Inwtallmlen,altcrallnn.3n1Um'relneatino
11X)amps or less An.10 1
— ._-_ -- �— 201 amplu 400 amts - I r>o N$ _ 2
— ...__ I'HOPKIt'rY l)WNF:It ❑
r-_....� TENANT_ p's f ( -
_._.... 4U1 am r Ito(04)am,s I o4.6(t
Ntlntt:. �' _-_.. ...._._.. 401 wap+lu I,(N)o amps _ 140.(d) 1
Address: Over 1,000 unryrs or vuhw 454.65 2
- Rmnnmect nnly _46.85 2
C'ily/Sta1cJ%II': 'Temporary,4crvlcc,rir feeders Installation,altoralinn,and/or
I'holtc (i J 7) S`�S? �tgS I'ux:( ) rcbcatinn --
unL Ito lltumvan 46.115 I
Owner inwlallation: 11tis installation is being mado on prolmrty Ihut i own which is nal 101 anops it)40C)amps IM.ln )
intended I'or snlc Icasc.rent,or exchange,ucurding lu ORS 447,449,670,and 701, qol rrrry,u to 600 amp:, 111'15 2
Owner Aignature' Mile; _ Rranch eirnrlm new,allernllmr,ur exlvn_s1on,per panel
C3APPLICANT_ ❑ CONTACC PMKSON A,ft:v.ler bnlnch circoilu with
-- - - ---- warvice or Icnicr lir.•carp
Ilut roosR name: brnnrh circuit 6.6ti 2
I-ce Ibr brant:h clnunx
Cooluut name: wtthr„,t scry cc.or ruedur fee,
Addn'cvs - - - c+a.h hr;nA.h elrcuf4 4&M.5 fd 8�� 2
Bach ud_d_I brunch circult -6.65 L k!6 _ 2
CIty/StatcMI I' Mlscellanlrrris(service rir keder not Included)
"hone:( ) __.. PAs:!( -----)-- ----- Pump or irrigalinn rheic_
Shpt or uoUinu lighting _ .5.1.111 -� )
1:-mo l: _ - Slgttul mrwlt( j or Ihnilcd- -- -
-('ONTRACCOR cnerty panel,lillcmtliun,or
liuilincss numc: mixt,mr ri.r.ci tic co -- uxtunxion.Ikwcrllx: Page 2 1
Address I834 SP Ara AVN.. Etith additional impeclino over alluwplde In aqy rif(lie shave•
Per ill-•pctIion 62.Sr1
lacy/State/%11': PORTLAND,OR 97214 - Invc'tipatinn per hrnv(I hr min) 62 50
PIMm:(SOJ',231-1949 _- l hT T
ux;(503)736.0677 huluwllial plum per hour 7.1.75 _
•. •- hi, t-1'HICAL PERMIT FFFS•
CY'ti I,ic.- 1.3.300 VIctaricul 14 26-135(' Sultrv. Lic. 26635
Subtotal
Sunrv. Llectrieian signufure,retioited; Plan review(25%of permit fc,:) �y
_ Sinic rulchorge(A"/6 of pcondl No)
Pllnlllnfile: N7
TOTAL PERMIT F'F;F: (. C7
Aulhurized Algna111rC: 'rile ptr•mh xnDI1M11Atl trynrell If A lttflrnl 6 nur nUldlraJ wtlhln Ito
Print name: _- Witte: I Jaya after it hpY Ikt OCNtp1cU en c•mglktr
I uo nrolhudolnpy set by Tri-t'nunty Ituildins Induvuy�ew,ce Ihwld
•'—•• ••Nnrrrlxrr nrloitolwiions pro hermit allowed
1nu1yIMY,PtrnMllAril r PctmwAgl liar, 1110.' 4,10.461 rr(I AM('oMlWlin
z •d LL90-9CL (COS) '00 01; 1z0at3 ap>ig %SaM aiT 190 *0 81 JdU
/
` CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2004-00183
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/12/2004
PARCEL: 2S111 CF,-01708
SITE ADDRESS: 10260 SW HOODVIEW DR
SUBDIVISION: HOOD VIEW ZONING: R-3.5
BLOCK: LOT: 00', ,JURISDICTION: TIG
CLASS OF WORK: OTP FLOOR FURN: EVAP COOLERS:
TYPE OF USE: S1= UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS-- 30 - 50 HP:
OD
GAS PRESSURE: 50 + HP:
CLO DRYERS:
FURN < TOOK BTU: 1 AIR HANDLING UNITS C
OTHER S:
FURN >=100K BTU: <= 10000 cfmGAS OUTLET: LETS:
> 10000 cfm:
Remarks: histall furnace and a/c
Owner: FEES _
JOSEPH SKACH Description Date Amount
10260 SW HOODVIEW DR
TIGARD, OR 97224iMliCHj 1'crmit Fee 4/12/200 $72.50
11XI 8°„State Surchari 4112/200-, $5.80
Phone: 503-598-9685 Total $78.30
ontracto.
CLIMATE CONTROL INC
16500 SW 72ND AVE
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Phone: ;111-453-4822 Heating Unt Insp
Cooling Unt Insp
Reg #: LIC 62196 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This pen nit will expire if work is
not started w thin 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center, Those rules are set forth in OAR
952-001-0010 throu h OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)24 9. ~�
Isis d By: - ""Co Permittee Signature: - 1 r
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Flpr 1P 04 09: 51a climate control 503 968 7224 p• 1
Mechanical PerWtApplication
Date received- i� Permit no.:
City of Tigard � - —�� ---.-
Address: 13125 SW Hall Blvd,Tigard OR 97223 Project/appl.no.: Expire date:
Ci��ujTigrrrd _. _ -----.-_
Phone: (503) 639-4171 Date issued: - By: Receipt no.:
Fax: (503) 598-1960 [��
no.: Payment type:
Land use approval_ _ permit nn.:
)fUl 8t 2 family dwelling or accessory O Commercial/indusiriaI O Multi-family O Tenant improvement
❑New construction ❑/'.cldition/alteration/replacernent O 0111f't
Job address; 10 a(yU Jlti Hcxx V�� Q{2 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg, no. Suite no.: va'ue of al mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit, Value$ __—
Lot: Block: .subdivision: 'S..e checklist for important application information and
Project name: �,0401 1 -3r jurisdiction's fee schedule for resid;-rih:l jwrmil fce�
City/county:-T t -]a�_q t
Description an�d�I allot of work on premi S. l r r 1 M.
I h e510.I1 ,.•e,,.n., Total
Est.slate of completion/inspection: U- /y -O� Description Qt . ties,only Ines,only
Tenant improvement or change of use:
-
Is existing space heated or conditioned?U Yes 0 No Air handling unit CFM _
Is existt,.g space insulated?O Yes 0 No Air con-�itionin (site Ian required) oo " t ;ix,
lira-tion o ex et ng VA'aystern
1 Boi er/compressors
Business name: ( 1 i+vtu Ce (=CVIh(1 $tate boiler permit no.:
Address _ 1 tor',c�p $� 1 h Ave -- �- '-M;e,xmc� tk`c dampers/ uct smoke detectors -
City: State:Oil Z.IP_g7 any ew pump(s to p un rcqu re
Phone;t�, -tt j-3_yg Fax: 1&&8 7� E-mail: _ T-mitt rep nce urnnce urner 7'[T1Ff" ca
CCL; no.: (ya 9 — including ductwotk/vent liner Yes U No 1y.
lnsle rep ac rc ocate cuter^ •suspen er,
Cityhnetro lie.n_o._1 U _ wall,or floor mounted
Name(please print): 1'ht gni fora lance uthrr than urnnce -_-`
eft gerat on:
Absc•rption units BTU/ti
Name. Chillers _ __ _ HP
Addtcss. Cnmprossors _ HP ---
Cit -nv:ronenen(xI exhaust an ventilation:
Y� � Slate: ZIP: _ Ap lance vent
Phone: -- - - I Fax E-mailDryer iance.aust Hoods-1—Type /IFes. itcheri/haxmat
hood fire suppression system
Narnr; JS��t-`'1 Exhaust fan with single duct(bath fans)
Mailing address: (p;;l,. � V �` .xhouct system a art from hcatin or AC y -
CitV ( _ _ stated zlp: 4�aa�l tie o P ng en distribution(up to 4 outlets)
`- Ty c: �— LPG N(i Oil
I'hamea -jq `I ! Fax; E-mail: ueI spin eac a mons n,erT outels
rocess p p np(sc emetic required)
Naltte: Number of outlets
Address: a -- t ger listed app ance or equrpment:
_ Decorative fireplace
City: Stale: ZIP: Insert =type
t Phone- _ _ Fax: Email: - ooatove ne et stove — —
Applicant's signature: Date: Other.
ther, _
Name(print): —� -
Nn1 aa1 jurndlconnA accept credit cards.pleere call juritdledon for mme infnanuann Permit fee .............. ..... $ - _
VimMasterCard Notice: This perntit application Minimum fee................ .$ '� �J�_
Credit curd number. expires if a permit is not obtained p;an review(at— �) $
within IRs)days aftrr it has been -- � —
�—Mume nt rnrd aider uc s awn nn credit card acccpted as complete. State surcharge(8%).... % � TTy_
sTOTAL........................ $
- _ ar o cr v pnurure y �mnunt
4411.4611 tn/rUCCIMI
t
Apr. 12 04 09: 51a climate control 503 966 7224 P. 3
aimATE CONTROL 3315 NW 26th Avenue Portland,OR 97210-1839
A&B HEATING AIR CONDITIONING
503-223-4393 FAX:223-4494
Is
SYSTEAIDESIGN INSTALLATION
SERVICE MAINTENANCE
TIGARD 1 684-3355 ST.HELENS s 397-250! VERNONIA s 429.0707 VANCOUVER s 254-3063
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503)639-4171 MST
BUP
Received --3. Date Requestad BUP
Location L "Z/Gf,(_/1)4Z.&j r122Suite MEC -
Contact Person Ph( _ ) 4/,S� ,3,., PLM
Contractor__- Ph( J ) — WR
BUILDING_ Tenant/Owner _ ELC __..
Footing— V I v u (,tr- ELC
Foundation
Access:
Fig ELR
Crawl Drain U
Slab Inspection Notes: SIT
Post& Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing — - —
Insulation
Drywall Nailing - -------
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - — — -- --
Roof
Other:
Final
PASS PART FAIL — - ---`
PLUMBING
Post&Beam
Under Slab
Rough-In /
Water Service - ------- ----- —
Sanitary Sewer
Rain Drains --__—
Catch Basin/Manhole
Storm Drain ------ -
Shower Pan
Other. _ _ ------- --- — -
Final
PASS PAT FAIL - —
I �1cL - __------ -_--------- -- -- ---
Post& Beam
Rough-In
Gas Line
5-43moke ampersART FAIL --
Rough-In — -
UO/P!:lb
Loy,Vol'age —�
Fir Alarm
3 -PART FAIL Reinspection fee of$ i required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SI _ _ [� P1enRe call for reinspec ion RE:_ Unable to inspect-no access
Fire Supply Line
ADA � / /
Approac)i%Sidewalk Dale _� —� 111lpaOlo
Other:_ __-
Final DNOT REMOVE this Inspection record from the Job, Ito.
PASS PAk FAIL