11373 SW LAKEWOOD COURT +1
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11373 SW Lakewood Court
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CITY OF TIGARD BUILDING INSPECTION AVISION MST
24-Hour Inspection Line: 639-4173 Business Line: 639-4171 — -----
BUP
Da`e Requr sled AM PM
- _ _ fr'I.D
Location /0 Suite
-- iAEC Zc;&d - G 0 3 U�
Contact Person PhU ✓� 4� G PLM _ -
Cons actor Ph _;3 SWR
BUILDING i'ar;a.-rt/Owner ELr:
Retaining Wall E�12 -- -----
Footing r. 'ess: - -- ----
Foundation f /_ r�-a < < �ci✓4/� FPS
Ftg Drain � 7'� 619GN-
Crawl Drain Inspection .tes:
Slab
Post& Beam - -- ---- -- --- SST --- ---
Ext Sheath/Shear
: t Shea!h/Shear --- -- -_.�--
I' rarning --�
Insulation —._____. ---_-._----------_.
Drywall Nailing
--
iFirc Sprinkler
Firs Xarm
Susp'd;.eilinc
Roof
Mise - - -- -
Final -
PASS PART FAIL -- - - - --- - - - ----- - -- ---- - -
PLUMBING
Post& Bearn ---- -
Under Slab
Top Out
Water Service
Sanitary Sewer - -- _
Rain Drains
Final - --
PAS FART FAIL
CHANICA _.- -- - -
Post& Beam '--- .�.— _w-- ----
Rough In
Gas Line -- ------ ----
'A PAkI- FAIL - — --� -�-
El .CTRICAL � ----- – -- ---- - – --- -- ----
Service
Rough In
UG/Slab
Low Voltage - --^
Fire Alarm
Final ---- ---_-
PASS PART FAIL.
SITE -- -
Backfill/Grading ----- -__�-
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ --_____required before naAt inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line ( ]Please call for reinspection RE: _ _ — -- _— - [ ]Unable to inspect- to access
AD-A
Approach/Sidewalk ^�----�
Other Date — �Ir3pector �_U� _Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY
OF
T I G A R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00305
13125 SW Hall Blvd., Ti q-a.d, OR 97221 (503) 639-4171 DATE ISSUED: 7/28/00
PAR;;EL: 1 S 134AD-01700
SITE,ADDRESS: 11373 SW LAKEWOOD CF
SUBDIVISION: ENGLEWOOD ZONING: R-4.5
BLOCK: T: 057 JURISDICTION: TIG
CLASS OF WORK: i-,LT JR FURN: EVAP COOLERS:
TYPE OF USE- SF UNi, HEATERS VENT FANS:
OCCUPANCY GRP: R3 VENTS '':;'.APPI-: VENT SYSTEMS:
STORi..S: �— _ BOILERS/CU_MPR_ ESSORS ;wODS:
FUELTYPES 0 - 3 HP: WlaiES. 1KCIN:
— V— 3 - 15 HP: s.;OMML. INCIN:
MAX INPUT: BTU 15 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR_HANDLING UR'ITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS, OUTLETS:
> IC'%0 Cf m:
Remarks: Replacement gas furnace.
Owner _FEES
JADIN, JAMES POWELL Tyne By Date Amount Receipt
11373 SW LAKEWOOD CT PNMT GWL 7/28/00 $50.00 0004045
TIGARD, OR 97;'23 5PCT GWL 7/28,'00 $4 00 0004045
Phone --
Tut;Al $54.00
Contractor:
AAA IDEATING + ("DOLING
2915 NE MART N LUTHER KING BLV
PORTLAND. OR 97212 REQUIRED INSPECTION
Mechanical Insp
Phone:284-2173 Final Inspection
Reg #: LIC 000002"2
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 mor� 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 ')AR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC, by calling (503)246-9189.
Issue By: `—��- ' Permittee Signature: `---____-� - ---��- --
6ll (503) 639-4175 by 7:00 P.M. far inspectinns needed the next business day
CITY OF TIGARD Mechanical Permit Application Plan Check#
�p on Rec'd By t"7777— -
13125 SW HALL BLVD. Commercial and Residentij?EGEIVED Date Recd ? -7 C
TIGARD, OR 97223 Date to P.E.
1503) 639-4171, x304 `Z
�= A[ 2 0 2000 Date to DST
int or Type ClY Permit#1.0 r< 2c�clr/.ma3of_
— Incomplete or illegible applications ii�n�o� beEv accepted
balled
Name of DevelopmonuProred Description —�
Table 1A Mechanical Code Qt Price Amt
Job Street Address Sune# A) Permit Fee _ —_ 16.00
- 1) Furnace to 100,000 BTU
Address 3L ) �� L. s(1O C f . including ducts&vents see footnote 1,2 1 9.65
bldg# ctj/State Zip , — - -
�) Furnace 100,000 BTU#-
-------_ T-16AfZD,o t� 9_1))L 3 including ducts&vents see footnote 1,2 12.00
Name(or name of business) 3) Floor Furnace
Owner I it l) J n D I N including vent_ see footnote 1,2 9.65 -_
Mailing Address 4) Suspended heater,wall heater
or floor mounted heater see footnote 1,2 9.65
1 1 ��� �/ LAKt toQOD U ' 5 Ven!not included in a pliance permit 475
CRy/State Zip Phone Check all that apply, 'Boller Heat Air
,� 7`)�)-JyU) For Items 6.10,see or Pump Cond Qty P ice Amt
Nai ne(or name of business) footnotes 1.2 Com
J t Vl ^� J 6)<3FIP;absorb unit to —
Occupant Mailing ddress _ ci�65
P I _ 7))3 3--OK BTU 15 HP;absorb unit
I I �i )' 3W LAr-f co(_)() L.T 100k to 500k BTU
CRY/State ZIP Phone 6)15-30 HP,absorb t-
f 11(4)RU (�(� Ial 3 p._ �„() unit.5 1 mil BTU _�- _ X4.15
- 9)30-50 HP;absorb
Contractor Nam
/, unit 1-1.75 mil BTU _ 36.00
\,r a HFA-rlA_I(s--f C QUI M6 _10)>50HP.absorb unit —
Prior to permit Melling Address _ >1.75 mil BTU _ 6.0.15
2- 15 _
issuance a copy �'� Iti1�1C 11 Air handling unit to 10.000 CFM
of a!I licensesRy/State Zip Phone
are required if r1) ZSR/_.?l 7 3 12)Air handling unit 10,000 CFM+
expired io COT Oregon const.Cont.91" Exp.Date _ __ 11.75 _
_database_ Ct, r;N\ 13)Non-portable evaporate cooler A
/':Chltect Name r 7.00
— 14)Vent fan connected to a single duct
Mailing Address __ 4.75
15)Ventila!ion system not included in
Engineer CRY/State Zlp Phare _ app' ice permit _ 7.00
9 16)Hood serve i by mechanical exhaust—
_ 7.00
Describe work to be done - 17)Domestic incinerators
12.00
New n Repair O Replace with like kind: Yes• No O 19)Commercial or industrial type incinerator
Residential 0 Commercial O _48.25 _
19)Repair units
Additional information or description of work _ 840 _
20)Wood stove/gas FP/other units/clothe dryer/etc.
7.00
NOTE: For Commercial projects only,Units over 400 lbs require 211 Gas piping one to four outlets
structural gas calks. _ See footnote 1 3 75
Type of fuel: oil 0 natural gas® LPG O electric O 22)More than 4-per outlet(eac _ .75
Minimum Permit Fee$_50.00 SUBTOTAL SOC i
hereby acknowledge that I have read this application,that the information _ — 16%SURCHARGE .rX.
given Is correct,that I am the owner or authorized agent of PLAN REVIEW 250%OF SUBTOTAL
the owner,that plans submitted are in compliance wd o=State laws — Required for ALL commercial) ermlts on�l r
Sign Owner/A Date
—� TOTAL
Other Inspections and Fees: — ---
_ 1 Inspections outside of normal business hours(mininum ch:vge-tvjo
Contact Person Name Phone hours) $50.00 per hour
x4-;21-73 2. Inspecdor,s for which no fee Is specifically Indicated (minin•um
charge-half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revis,ons to
1 Provide full schematic of existing and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour
2 Provide drawings to scale showing existing and proposed mechanical
units ` _ -- 'State Contractor Boiler Certification required
"Residential A/C requires site plan sho,vmg placement of n:-,!
1:lmechperm.doc rev 0/4/99