Permit --_-� `
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CITY � � �� �m ��� N�m�� � am � N������� DKN��' MECHANICAL •
DEVELOPMENT SERVICES ��u~�a~m~��n x�nm~n� o *�u~xx�n*~m~*� PERMIT
- ���� ��SSN/Hail �x 9���G0�4/7Y • ., : , PE R MIT #.......: MEC9B
• � ` DATE ISSUED: 09/21/98
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PARCEL: 2S101AA-06400
SITE ADDRESS...: 12323 SW 66TH AVE , `
SUBDIVISION..-.: WEST PORTLAND HEIGHTS ZONING: C-G .
BLOCK,.,.......: LOT.............:024 JURISDICTION: TIG .:
______ -----
CLASS OF WORK..:ALT : FLOOR FURN....: 0 EVAP COOLERS: 0
TYPE OF USE.... :COM UNIT HEATERS...:-0 ' VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/O APpL: 0 VENT SYSTEMS:' 0 •
S|ORIES. ..... .. : 0 BOILERS/COMPRESSORS HOODS,: 0 �
FUEL TYPES------------ 0-3 HP....: 0 DOMES. INCIN: 0 '
:GAS ' 3-15 HP.: 1 COMML. INCIN: 0 •
MAX INPUT ...
': 0 BTU � 15-30 Hp....: 0 REPAIR UNITS: 0
FIRE DAMPERS?..: N 30-50 HP....: 0 • WOODSTOVES..: 0
GAS PRESSURE.. . : M 50+ HP....: 0 CLO DRYERS.. : 0
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 0 BPS TLETS.: 1
FURN >=100K BTU: 1 ' • ! 10000 cfm: 0 ,
.Remarks: Mechanical TI .
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Owner: ' -.------ ------ -_------ ------ FEES --- -�-
ASIAN AMERICA type • amount by date recpt
2300 E 15TH #13 , � !DWI' $ 25.00 B 09/03/98 98-308825
_ VANCOUVER WA 98661 - PLCK $ 6.25 B 09/03/98 98-308825
' ` . 5PCT $ 1.25 B 09/03/98 98-308825 •
Phone #: ' ` PRMT $ 5.50 B 09/21/98 98-3093
04 . �
' PLC'', $ 1.38 B '09/21/98 98_30930
4 • .
Contractor: ---------- --------_---- 5PCT $ 0.28 B '09/21/98 98 •
4
THE HEATING SPECIALIST • � � . •
9300 NE HALSEY ------------�--� ------�----
' � $ 39.66 TOTAL
PORTLAND OR 97220 '
. Phone #: 257-7000
Reg #..: 000566
� - REQUIRED INSPECTIONS -------
• This permit is issued subject to the" regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp __
applicable \awa. Al} work will be done in accordance with Heating Unt Insp ___ .
approved plans. This permit will expire if work is not started S. D. Shut -down ' � _ __�
within 180 days of issuance, or if work is suspended for more Final Inspection _ __
than 180 days. ATTENTION: Oregon law requires you to follow roles _ '
adopted by the Oregon Utility Notification Center. Those rules are ______� ___ __
` spt forth in OAR 952-001-0010 through OAR 952'M-0080. You may _ __
obtain copies of these or direct questions to LUX by calling, • _
(50246'9187' . , , ____� ________
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____ _________ _____ _____
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Issue By: �"�k��-� L ' Perm Signature:-&N
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+++++...........„,++++++++++++.±....,++,............... • Call 639-4175 by 7::00 p.m. for inspections needed the next business day •
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Plan Check,„ 1-(2-C' CITY OFJIGARD Mechanical PermifApplication Recd By P.
13125 SW HALL BLVD. Commercial and Residential Date Recd 1
TIGARD, OR 97223 Date to P.E. '
(503) 639 -4171, x304 rl Date to DST 'i�[� �.
� �M �Pq6 � Z
Print or Type �16 Permit # M - ' : -- #V�
1 � Incomp ete or illegible applications will not be accepted called 9 - 98 Leh
Name of Development/Project Description
• Table 1A Mechanical Code QTY PRICE AMT
Job street Address SLAWS A) Permit Fee -0- -0- 10.00
Address 12323 SW (, o
( !0 /
Bldg# City /State Zip 1.) Fumace to 100,000 BTU 6.00
`Ti `1 Ord ' '7 2 including ducts & vents
• Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50 i 0
Owner ,O-o�_�n C�C! rr_tL.c C o,_., including ducts & vents `/
Mailing Address 3.) Floor Fumace 6.00
• 2300 E. i S 11 including vent
C /State Zip Phone 4.) Suspended heater, wall heater 6.00
y -n c o u J LA 9 C or floor mounted heater
Name (or name of business). 5.) • Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
( 32_3 S W Le la 4 to 3 HP; absorb unit to 100K BUT" - -
• Cily fate Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
• 2 )z 3-15 HP; absorb unit to 500K BTU° ( L'i P I
Contractor Name - 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to aZ11.)2._ %h--a - ?-• . 15-30 HP; absorb unit5-1 mil BTU"
issuance Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
applicant g300 Al2.. kiA L y 30-50 HP; absorb unit 1 1.75mi1 BTU"
must provide all City/state Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor _ fir Ti -Arm q 72 i a S7 -7oc > 50 HP; absorb unit 1.75 mil BTU"
license Oregon Cons. Corn. Board Licit Exp. Dare 11.) Air handling unit to 10,000 CFM 4.50 •
information 5 ( (, .25" 1 9
for COT COT Business Tax o Metro t .Date � 12.) Air handling unit 10,000 CFM . 7.50
database).
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address - 14.) Vent fan connected to a single dud 3.00
Engineer CaylState 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
to be done Residential 0 Non - residential 0
Additional Description of work 17.) Domestic incinerators 7.50
(.....":2-.4 /.40-t-t-I2-e-.. 18.) Commercial or industrial type 30.00
am/) -.0-.0.--rut-E.... Incinerator '
Existing use of 19.) Repair units 4.50
building or property C 2� -fie. 7-
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property fx -e-a.. .
22.) Other units 4.50 .
Type of fuel - oil 0 natural gas SS( LPG 0 electric 0 23.) Gas piping one tofour outlets 2.00
A
I hereby acknowledge that I have read this application. that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL .
laws. •
Signature of Owner /Agent Date 'SUBTOTAL
• 5% SURCHARGE
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Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL t
l= /P /S' / C,, X 57. 7naci ,
TOTAL
a -
i:1ds pmt v 9 'Minimum permit fee is S25 + 5 %.surcharge
"Residential NC requires site plan showing placement of unit.
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CITY OF TIGARD • ••• • • •
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Approved 1V1: 7
Conditionally Approved 1 1'
• For only the wor as described in: II
PERMIT NO.
Seer LettQf to: Follow./ 1 1: . .
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Attach [ 1: :: 1
Job Address:
0 By: 0..12 Date:411$ N ta —
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
I 03 ' p BUP
Date Requested l — j AM PM BLD
Location ' (2 313 SW WQ /' 6i Suite "7 ,3)0
Contact Person - Ph PLM
t r
Contractor 4v t - A e AT I N SP ( S t Ph Z57- 7ooy SWR
BUILDING Tenant/Owner g4e -Meg i (OS SCArr ELC
Retaining Wall ELR
Footing Access:
Foundation ' 4 - �b�SS FPS
Ftg Drain v�1 SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear •
Ina Sheath /Shear / \
Framing _
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 5 6i i \ PO
Susp'd Ceiling (
. Roof
Misc:
Final
PASS PART FAIL
PLUMBING -
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
.CHANIC _
Post & Beam
Rough In
Gas Line
Sm, ke Dampers -
Via PART FAIL
- ICAL
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 next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk
Other Date 74 q,� Ins Ext
Final -
PASS PART FAIL • DO NOT REMOVE this inspection record from the job site.