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CITY O F T I C A R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT X: ME^2003-00563
13125 SW Hall Blvd.,Ti7ard, OR 97223 (503)639-4171 DATE ISSUED: 9/15/03
PARCEL: 2S 111 CB-00102
SITEADDRESS- 10150 SW MURDOCK ST
SUBDIVISION: ZONING: R-3.5
BLOCK: LOT: JURISDICTION- TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES _ 0 - 3 HP: DOMES. INCIV:
LPG 3 - 15 HP: COMML, INCIN:
MAX INPUT: BTU 15-30 IIP:
FIFE nAMPERS7: 30-50 HP: REPAIR UNITS:
GAS vRESSURE: 50+ HP: WOODSTOVES:
C
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN >=100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remi, istallation of gas fireplace insert and gas piping.
Owner: _ FEES
ALEXANDER, RONALD E 3 MARY T Description Date Amount
10150 SW MURDOCK [MECH]Permit Fee 9/15/03 $72.50
TIGARD, OR 97224 [TAX] 8%StateTax 9/15/03 $5.80
Phone: 503-639-0359 Total $78.30
Contractor:
G P &W SYSTEMS INC
732 MARBLE RD
WASHOUGAL,WA 98671-9601 REQUIRED INSPECTIONS
Phone: 360-835-3516 Gas Line Insp
Final Inspection
Reg#: LIC 108176
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W This permit is issued subject to the regulations contained in the Tigard Munic;pal Code, State of Ore. Specialty Codes
-� and all other applicable laws. All worst will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or ;f 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 952-001-00
Issued By: �.� . Zc Permittee Signature:
Call (503)639-4175 by 7:00 P.M.for Inspections needed the next business day
- -09111103 T811. 18:43 FAX 3608355716 Ke+nt:_& Lynne
00,
Mechanical Permit Application
ons
Cit�,l of T and D•(crecctved:qel Permit no.
y g ,,Q �C���/ ProJocu app—I.-oo�.r:L� Expire daft:
Cityof77gard Address: 13125 SW Hall 13REG& FED l.Do.:
Phone: (503) 639-4171 Date iesued• B Receipt no.:
Fax: (503) 598-1960SEP ' , mi , Cue file no.: ttype:
Land use approval: - permit no.: IC,
U I &2 family dwell ng or acces-tory U Com.nercisNindusMal U Multi-family Ci Tenant improvement
U New construction L' ' '-4ition/alteration/neplacempnt U Other.
Job address: 10150 SW M V OCAL Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.oo.: Suite no.: ralue of all mechanical mataWs,equipment,labor,overhead,
Tax ma tax lot/account no.; profit Value S
Lot: Block: Subdivision: 'See checklist for important application information and
Project name: urisdiction's fee schedule for residential permit fee.
City/county; ZIP: _9 LL _ mumnloolEu�mus all
Description and location 01 work on premises:_
'0/
— _ rFc* Totdfcoon; �'j�*� I Damildoe Ra
edy
Tenant improvement or change of use:
Is existing space heated or conditioned?0 Yes U No Airhandlin unit CFM
Is existing space insulated?0 Yea 0 No uoe an C'lyse m
taa on ex et ng .eysoerrr
o er rompreelore
Business name: �� 4- U-3 SkS4,Q o !State boiler Permit ab.:
Address: 3 — ILP Tone $Tuna --
emna uct smote etectors
City: l.l)¢j o� State:W ZIP: �-�u- (site pian rrqulredf---
rho $ Sff� Fax:�j3S E-mail: natall/repiacc furnac )rr7l-unci— —"
CCB no.: 10 5? f Co- -ylr. OS Including ductwork/vent liner 0 es 0 No
' ns'1Drap ace re ovate stere- ape
City/metro tic.no.: 3-419-:5- dl,or boor mounted i
Name( leaae print): — ent ce o ornate
Absorption unlrs BTU/"
Name: L4 h h! T'f IFILC.a - i.G
Chill
a HP
Address: 3�0 g3�.3 HP
City: — Zip: --- r,:
Ilancx vent
Phone: Fax MF__mail set ----`-- _ -
e,Type Mr—es. r-iat -
hood fire,mppression sew
Name: "_I�r%al d, JR;xhaunt fan with s�ini�d ns)
Mailing addmss: 1Q( � - �h aQ , -- austa stem artfron _V� _
IL City: fL�� State: ZIP: a 'to�otn ets
e: W°(7 ?VO (Ala Phone. Fax: E-mail: rypIffue TTn-eat each, offo -
Wn
stie requ )
Name: ----^ -- umberofoutlete --
Addreis: MWed
ce er
�xotative lace
m City: I State: ZIP: inaert-DZ a
Fbone: 1W pelletwove.
ru f',pplica.mt's signature: Date: _
a Name tin►;: - — -
-Ell
Not an iadodietlom roept coo dtds,place can isrid Wan Por malt k/ansetion. Permit fee.....................
OVua l]Mute><'erd Notice;Thispamit application Minimum fee............
r�,e,il ..t cmd no.Aw._ expires if a permit is not obtained s
) s
within Igo d�aye aft,it has been State�w(ar
Name ofd Are neem on i ate_. acOEpeDd QnmpinAe. hie(g
fry — or' TM/�............ .........S
Amos
/ 4404617 MM)C M.
� N . �� ��
CITY OF TIGARD 24-Hour
BUILDING Inspection Linen 1,503),6.45-4175 MST
INSPECTION DIVISION Business Line: (503)635-4171
/ BUP --
Received Date Requested�r ` AM 1/�PM___— BUP _
Location -1-01-55-0— dd _ ----Suite __ M�c
Contact Person . _ Ph( -) . X03 � 9 PL
Contractor �� __- Ph(- -
BUILDING Tenant/Owner � ELC
Footing ELC
Foundation Access:
Ftg Drain 1/ Vl^ ELR
Crawl Drain
Slab Inspection Notes: _ — SIT —
Post&Beam _. -
Shear Anchors ,�f (44Z_
.
Ext Sheath/Shear --•---
Int Sheath/Shear
Framing -- -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler - -- i
Fire Alarm
Susp'd Ceiling ---'�— - -
Roof _
lQ,,�3
Final
PASS PART FAIL O � � j
PLUMBING -
Post&Beam
Under Slab ---- -
Rough-In
Water Service - -
Sanitary Sewer
Rain Drains - --
Catch Basin/Manhole
Storm Drain -
Shower Pan
Other: --- --- --
Final
PASS FAIL --- --�� -�-�- - � -
osf&Beam �• P _-= - _ _�
as i 1
a $m_ Dampers --- - -- —_ -
pC (Fina.
~ PASS PART FAIL ---- ---� ---- - —--
CO) _
ELECTRI AL-- - -- ----- -- --_ --- -_
.J Service
m Rough-In -
UG/Slab
W Low Voltage .-- ---- -- _--— — — —_- ----__-
_j Fi-e Alarm
Fina, F] Reinspection fee of$_-_ -- required before next inspection. Pay at City Hall, 13125 5W Hall Blvd.
PASS P^RT FAIL
SITE riesse call for reinspection RE:_�_-_____ —_ Unable to inspect no access
Fire Supply Line
ADA
DIM
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection noord from the
PASS PART FAIL