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16810 SW MATADOR LN
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 6394175 Business Line: 639-4171 _
_ BUP _
Date R��xxe��,,quested ' AM PM BLD
J�cv
Location 1 - ::;cite
Contact Person - y�==�f� J Ph 14�1 SZ) PLM
Contractor _ Ph SWR
BUILDING Tenant/Owner �i=�l � ELC
Retairing Wall ` —" 7 ---� �L' ELR _
Footing Access:
Foundation FPS
Fig Drain — SGN
Crawl Drain Inspection Notes:
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
Post& B3am — --- - — -
Under Slab
Top Out
Water Service
Sanitary Sewer —
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post&Beam --- --- ----- —
Rough In
Smoke Dampers
'PAS PART FAIL
FCTRICAL ---- — —
a Service
Rough In —
N UG/Slap
Low Voltage —------- - — - ---- —--- —
Fire Alarm
J Final
m PASS PART FAIL ----__-
OSITE
W
J Barkrll/Grading —
Sanitary Sewer
Storm Drain [ ]Rein3pection fee of$ _required before next inspection. Pay at City Hall, 13125 SW Hell Blvd
Catch Basin
Fire Supply Line [ ]Please call for reinspection RE:— —_ [ ]Uneble to inspect-no access
ADA
Approach/Sidewalk Date la_ �el inspector Ext
Other
Final
PASS PART FAIT_ DO NOT REMOVE this Inspection record from the job site.
CITY OF TIGARD MECHANICAL PERMIT _
DEVELOPMENT SERVICES PERMIT#: MEC2001-00346
13125 SW Hall Blvd.,Tigard,OR 97223 (503) 6394171 DATE ISSUED: 10/4/01
PARCEL: 2S116AD-14900
SITE ADDRESS: 16810 SW MATADOR LN
SUBDIVISION: KING CITY NO. 17 ZONING:
BLOCK: 19 LOT:009 JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT "EATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 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 OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install gas furnace, ductwork, venting and gas piping.
Owner: _ FEES _
VALERIE JERMOL Type By Date Amount Receipt
16810 SW MATADOR LN. PRMT BB 10/4/01 $72.50 KING CITY
KING CITY, OR 97224 5PCT BB 10/4/01 $5.80 KING CITY
Tota! >b78.30
Phone:503-246-5300
Contractor:
A-TEMP HEATING+ COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Gas Line Insp
Phone:650-5014 Mechanical Insp
Reg#:LIC 71878 Heating Unt Insp
Final Inspection
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
-J 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 forth in OAR 952-001-0010 through OAR
952-001-0080. You may obtain copies of these rules or direct questions to OUNC by calling
Issue By: Permittee Signature:_ 0 7 4i
Call (503) 6394175 by 7:00 P.M.for Inspections needed the nexi business day
10/02/2001 0- 5036393771 CITI' OF KING Y PAGE 01/01
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— -- ��- �� ..UJVJ JJ/ r U.L 1 V ur K1MI to IY -1 PAGE 02
.SIR CT,NTE ' Mechanical Permit Application
City of Fling City � rat.►�alvad: � , , P.nnit tw
13125 SW Hall Blvd, � Pm aedappl no.- 8>, 'rs date:
Cinckama_S ['igucl, OR 97223 Due irsued: -- ley; Receipt no.:
Multnomah Phone: (503)639-4171, FAX; (5(13)h8+► 7297 CAM file �. Payment type:
Washington ---
c o • Land use approval. _ Huildial permit no.:
' I
t 6t 2 family dwelling or accessory O Comroarcial/indut;rriai 0 Multi-farttliy 13'rermt Improvement
O New construction O Addition/alteration/replacement 0 Outer:
Job addrefs:
Indicate equipment quantities in boxes Wow.Indicate the dollar
Suite ten.: value of!ell mechanical natari0s, equipment.labor,overhead,
Tax ma /p tax lot/account-no.; profit. Majus S ._ ---
Lot. 91ock Subdivision: "5&Vcheckldsrforl»tpoaarnrepp/k:ariwrd,�Iamurdprand
Project name: 'C _� "�" �,�r(sddcrloot's a echedwte r>'riddrnttial rmdr�6e•
i Cit /county: ti� ZiP•
ity -_
I�cails
satpuon and location of r on PTrM sea;
Y—s4t — 't r Pee(we,) Total
t_ date of cr-m Ietio ns tion: _ Dwott to ales a' Les.oaly
�--FA--- — ._-pi---__P
Tenant improvement of change of use - A
is existing space_heated or candidoned7 O Yes O No Air handling unit CFM
Is exladng spaei insulstted7 U Yea G,4o u condlu°- '«m-pl" nrequired)
Altem 0n o e st jt syrtsnt
o ler/compres etre "�—
Busumsa name: a state boiler permit no.:
AtlrJrnse; s Eip Ton. STUIH
tre/ltfi0 a ant uct stmoke ore
CIry: �„ � Start 0 ZIP �Z�i,S at tem (cite� rtret�
Phone: Fax:_ E-mail; Inst lace funscAlburriv
CC 13 no.: 1\g"^ Includin ductworldWitt liner yrs O No
Installhep acdtr orate heaters-ruapended.
City/metro lac,no.: wall.or floor nsounted
Name(please t): T eator�p iance otner thea aea T --
et`f�"arsr�-
Absorption unite AMM
Name. 1 y Chillers HP -
AddreSs: cam re' sots HP
City: State: ZfP; o oamastut eta ram a:
Phone a Fit: j3 rsUl: - - A liance vont
Dryer exhaust
km 21Hc1�a 'type res, itc Ararat
Name: hood fire ruppmStion system
IL ' �� �,.. $zhaurt fan with st'nak duct(uta)
p� Malting ddrtss: Ls zhnust s resin"— rom heattn o—r A�
City' State: ZIP: tel P p"gas ort(up ra 0WIVtl
_.� _�.._ Cel � T LAO NC OU
Phone; All, E tlQail: ue, i in etch 100011 overt out Cts --
J �P A■d(tc uratic requtr )
ED- Name: Number of outlets
a A+ddrtss � _NWIF iR epp as or aga ptnent:
r City; -- Decorative flee (ace
J i__ _ - Sure 2IP:_ neem Me
-
Phone: ax: T F'mait: oodstov le(stove
I_Appldcont'.s slq re Date: t r
` Name print); ~~- t�ht+r: - -- _
rNo-411 1'.rMi<ti6m,tope rr d"Cads Plc ur"41;-1 Wiulo4 lel mvro ie O"tW104 Pertttlt fee „,� (�
I O Vise Q Ma1terPard Neeue. 01j"mnkf applkadon MlnlmtJtn fee . ..
GrNh card"Umber. f arpl yr if a 0ernslr lr not obralned Pleur review(at........d,) S _
wkhln JAM dayr aJln!e hal been State:view( a
f NtmeorcudhefAer, fhoweee it�eld '
_ aeeopfed air c*wpkre. 13e(9911).•...S
L•^•— -- C'rdh--- It'"'Ij6M•ra A' Amar TOTAL.................. ....S
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