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A CITY OF TIGARD
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13125 SW Hell Blvd.EVELOPMENT, Tigard, OR 97223S (503)(39RVICES171
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Plan Chet),
Mechanical Permit Application Reed By( t 1,40CITY OF TIGARD '
13125 SW tIALL BLVD. Commercial and Residential Date Recd tt e+ 4;77-
TIGARD, CAI 97223 Date to P E
(503) 639-4171, x304 ,. - Date to DST
Print or Type Permit 0 k1'I�Ql -01,' )
Incomplete or illegible applications will not be ted
acce CalledP --- 9---- -Pp P
Name of 0•veapnienvPro sct Description -
' r ' ,t 1 , Taule IA Mechanical Code CITY PRICE AMT
Job Street AddreM Suets A) Permit Fee -0- -0 10 C i
Address �- �,i ;
Blega - Cifyrstat• Zip 1 ) Furnace to 100.000137U -600 '
n 11) includin•ducts 8 vents I_ n�'
Nome,of name atbusnes4) 2) Furnace 100,000 BTU+ -- 7 50
Owner •l 1 i including ducts 8 vents
Mame onis 3 I Floor Furnace 66 00
including vent
"Oey/Slat• r-'Zip phone 4 1 Suspended heater, ill heater -`-6 00
or floor mounted heater
Name for name of business) 5) Vent not included in appliance permit 300
Mair A -�_..- ? A�
Occupant g ddnsa 6) Boiler or comp heal pump,air cond 600 J -
to 3 HP.absot unit to 100K Bi Jr'
CepState Zip Phone 7) Boiler or comp.heat pump,air cond 11 00
1-15 HP.absorb unit to 500K BTU"'
Contractor 1
Nana 8 i Boiler or comp,heat pump,air cond 15 00
' 15-30 HP absorb unit.5-1 and BTU**
Prior to .r1 1 Intl 1L'd L
permit Maung•Add ,s 9) Boiler or comp.heat pump,air cond 22 50
issuance,a copyi ie'''''
L........- L may, j _ 30-50 HP,absorb unR 1-1 7Smd BTU"
of all licenses CitylStat• Zip Phone 10) Boiler or comp heat pump,air cond 37 50
are required if +.- ',.1 '�2742L,I i i
..,.. -if, LL ((� >50 HP,absorb unit 1 75 and BTU"
e.pared in COT ,..4.•-•
Or•vbn Conn Cam eoard i.,c a p Data
� 11 ) Air handling unR to 10,000 CFM 4.50
database y "1 t' 1? i I.
Architect Ne 13) Non portal.ie evaporate cooler ~- 4 50
Or Mooing Address 14 I Vent fan connected to a single duct 3 00
City State -�
Engineer Zip Phone 15) Ventilation system not included in 4 50
appliance permit
Describe work New 0 Addition 0 Alteration 0 Repair 0 16) Hood served by mechanical exhaust 4 50
io be done Residential o Non-residential 0
-
Additional Description of work -- - ,
17) Domestic nc•neralors 7 S0 1
18) Comniercial or industnal type 30 00
_
Incinerator
E fisting use of 19) Repair units 4 50 -
bu'ldirg or property - -
-
20) Wood stove ~ 4 S0
Proposed use of 21 ) Clothes dryer etc — 4 50
building or property
22) Other units 4 50 '
Type of fuel-oil 0 natural gas 0 LPG C) electnc 0 23) Gas piping one to four outlets 2 00 "
I hereby acknowledge that I have read this application that the 24 1 More than 4-per outlets leach) 50
information givens cc ect,that I am the owner or authorized agent of
the owner,that plans submitted are in compliance with Oregon State OTY A SUBT 1
laws O L
Signature of Owner/Agent Date 'SUBTOTAL
it ,rA
. / ; r 5%SURCHARGE v.-
/, (4,,
r Contact Parson Nama a ` L -I'
///' � -- --..
r hone PLAN REVIEW 25°,OF SUBTOTAL I
- L y/1 TOTAL r
1 !x^1 /
(.4,;6#;Li
rVnechpmt doc (rev 9 'Minimum permit fee is 875+5%surcharge
"Residential A/C requires site plan showing placement of unit
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5 37g
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 "--
- `
`
Bate Requested AMBUP
PM BLD
Location / / 1 w GGG v►-cA- Suite _ MEC
Contact Person Ph - .3 (8' y G 7 p /--lir v4. O G(
Contractor Ph SWR --
BUILDING Tenant/OwnerELC -
Retaining Wall _ ELR
FootingAc�Ss
Foundation FPS -
Ftg Diain — --- SGN
Crawl Drain Inspection Notes
Slab `' <. • SIT
Post 6 Beam
Ext Sheath/Shear _
Int Sheath/Shear
Framing
Insulation a _ —
Drywall Nailing 1 tA..�hM- -"i `!��' L��Q✓ �J1/
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof
Misc •_ --
Final ..1 j
PASS PART FAIL U e At } `S ‘A.. Q .L 1 Q
s Beam —
Under Slab „ -
Top Out ——�
Water Service
m
(,:r Rain
SS PART FAIL _
HANICAL
Post & Ream
Rough In
Gas c,ne
Smoke Dampers ,
Final — t
PASS PART FAIL
ELECTRICAL
Ser ice
Rough In
UG/Slab _
tow Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading — -- -- - —
—
Sanitary Sewer
Storm Drain I J Reinspection fee of$ - required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply tine ( I Please call for reinspection RE I J Unable to inspect - no access
ADA C, / _
Approach/Sidewalk Date -7/ 1 I u inspector \4 �' `�— Ext 3 t
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the jnb site.
I
07/20/2001 10:04 5032590433 KU��LER PAGE 01
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>_._ _______________________________,n.
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CITY OF TIGARD BUILDING INSPECTION DIVISO�
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: ` 11 i I A.M. i / P.M. MST:
Location i i I ii,t1 C Y. i` _ + BUP:
Tenant _ _ Suite: Bldg: M1?C• • ; ....1• . T-
Contractor _ c l ' , 4 {'hone �[ ' {1 • .� l 1 PLM.
Owner: Phone ELC:
EI.R:
Sfi.
BUILDING BLDG(con't) PLUMBING Mf('NANICAL ELECTRICAL SITE
Site Post/Ileum I'ost/Iteam Post/Iteam Cover/Service Sewer/Storm
Footing Roo( I/ndfl/Slab Rough-In Ceiling Water Line
Mat, Framing Iop Out teas line Rough-In 11(3 Sprinkler
foundation Insulation Sewer 1lood/i)ul Reconnect Vault
Ilarnt I)atnp I)rvwall Storm iliniace I imp Service MISC.
Masonry Ceiling Rain Dram A/C I i(i Slab
Shear/Sheath fire Spklr/Alm c'ruwl/foimd I)r I leat Pum I ow Volt
Approved Approved c� Approved Approved
Appr/Sdwlk Not Approved Not Aptnoved Not Approved Not Approved Not Approved
FINAL. FINAL FINA.L FINAL
I Call for rein. tion n keinsi*tam lee of$ _ requir before .t inspection I Unable to inspect
Inspector _ Date / 2b 9 t I
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