Permit CITY OF T MECHANICAL
//Nin/ t s r DEVELOPMENT SERVICES PERMIT
'-W. - L� � 13125 SW Hall Blvd, Tigard, OR 97223 (503) 639.4171 PERM I T # MEC98 =0283
DATE ISSUED: 07/16/98
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: 6
STORIES • 1 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP : 0 DOMES. INCIN: 0
3 -15 HP • 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP s 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP : 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Replace flexible air duct, realign diffusers. No new units.
Owner: FEES
FARMERS INSURANCE EXCHANGE type amount by date recpt
12323 SW 66TH AVE PRMT $ 27.00 DLH 07/16/98 98- 307400
PORTLAND OR 97223 PLCK $ 6.50 DLH 07/16/98 98- 307400
5PCT $ 1.35 DLH 07/16/98 98- 307400
Phone #:
Contractor:
ARMSTRONG COMPANY
2224 NE 37TH AVE
34.85 TOTAL
PORTLAND OR 97212
Phone #: 784 -3747
Reg #... 128321
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Duct Inspect i o n
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for sore
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by 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
(503)246 -9187.
Issue By: � . Permittee Signature: -✓�` I .�
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + ++ + + + + + + + + + + + + + + +
�' Plan Che
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential ; Date Recd / -!
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type ��,, _ 27 ( 1 Permit # / 9e- 0 29-3
Incomplete or illegible applications%irill iiot be accepted Called
Name of Development/Project Description •
P t12 .,.r_ n S 1.,-15./4 a Table 1A Mechanical Code Qty Price Amt
Job Street Address Sude# A) Permit Fee_ 10.00
1 Z• l 'S.L•S C / 1) Furnace to 100,000 BTU
Address D (9 including ducts & vents 6.00
BMg# City/State Zip 2) Furnace 100,000 BTU+
g e9/Z'TL,A+u� including ducts & vents 7.50
Name (or name of business) 3) Floor Fumace
Owner eq>..ns tۥf5tJ 2 ' including vent 6.00
Mailing Address 4) Suspended heater, wall heater
// or floor mounted heater 6.00
�Z3 2 Sc.) . l9 5) Vent not included in appliance permit
C• State Zip Phone 3.00
9A- n-4-1 CHECK ALL Boiler Heat Air
Name (or name of business) THAT APPLY: or Pump Connd Qty Price Amt
D �� ,�
'ME 4 5 tr' J'e't"' "4.._ 6) <3HP;absorb unit to Comp
Occupant Mailing Address •100K BTU - 6.00
l7-27 Z,s 5%4 (0( 7) 3 -15 HP;absorb unit
City/State Zip Phone 100k to 500k BTU 11.00
Po al Lfl 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 15.00
Contractor Name ,/ 9) 30 -50 HP; absorb
/ikyv
V o+J(a Co MQa.� 1 unit 1 -1.75 mil BTU 22.50
Prior to permit M iling Address - 10) >50HP; absorb unit
issuance, a copy 1.224 NE- 31 >1.75 mil BTU 37.50
of all licenses /Sttaatee , , /� Zip Phone 11) Air handling unit to 10,000 CFM
are required if rO P-1 �.�t�' 4 -. ) '1 7 Z-i Z v45-74 7 4.50
expired in COT Oregon Const. Cont. Board Lic.# • Exp. Date y/ '12) Air handling unit 10,000 CFM+
database Its 7 2i t 3 / ?.�o O 7.50
Architect Name G 13) Non - portable evaporate cooler
De t , vA (...LV12-E 4.50
or Mai Address
5- Mailing 14) Vent fan connected to a single duct
7
70
W''( Gjt'R-E 3.00
15) Ventilation system not included in /�
Engineer City /State Zip Phone _. appliance permit (0 4.50 27
P o ia tAr•rJ� U G cip ,3 16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New 0 Repair Replace with like kind: Yes 0 No 0 7.50
Residential 0 Commercial 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
4.50
Rt/l5i. bucTwis -K- 1 b, . 20) Wood stove
4.50
ii eCo N &,1 FLook P( -,4,J 21) Clothes dryer, etc. .
4.50
Type of fuel: oil 0 natural gassiii LPG 0 electric @k 22) Other units
• 4.50
I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets
given is correct, that I am the owner or authorized agent of 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Si... • - • • Owner /Agent Date s ?
*SUBTOTAL .
4 (//(/Z-,-, 1 ...v. 7 ii Iv 5 %SURCHARGE a
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL « -- !-
Required for ALL commercial permits only a G li
Pre I K �`�'� '� TOTAL dp r
4.
Q 2 "Minimum permit fee is $25 + 5% surcharge
• *
7(J > ?Q **Residential A/C requires site plan showing placement of unit
I:Unechprm3.doc rev 06/23/98
OVER- THE - COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: F /eg (-€ tea ,.r G 74 c'p A / y �
GP tt ,rrJ,
$- 'mow 'A hit
Class of Work: 44 P Floor Furnace: Evap Coolers:
Type of Use: ('G 7 Unit Heaters: Vent Fans:
Occupancy Grp: 63 Vents w/o Appi: Vent Systems: 6
Stories: o71 a Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
/ / / / 3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: < = 10000 cfm: Oth Units:
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn > =100k Btu:
NOTES: A - n _r c vi t o. - (Pei.? �t c -C Ale ms
f • ,,.. TZ / "r,, l
$ j7 Permit Fee
Gas Line Inspection $ f Plan Review
I V Mechanical Inspection $ ' 7 r 5% State Surcharge
Cooling Unit Inspection $ Additional Permit Fee
Shaft Inspection $ Additional Plan Review Fee
Hood Inspection $ Inspection Fee
Fire Suppr Inspection $ Miscellaneous Fee
Duct Inspection � y
Fire Alarm Inspection
Fire Damper Inspection REMARKS:
Miscellaneous Inspection
Fire Alarm Inspection
Final Inspection
:CiASS::D�:woR •. • :::IbN :..: .: Vtt.. -: i
K.Of�'#' .. S.EQRALL;PERMITS' NE. ... aew ::A£3F3... addit on ALT•::. -: aEterat�on RGS '..$ccesso .::;`.': �.:': ?: >�: >: >.`:��_.��; >�:::< € >: <: >::,
'F.:NI� s:fi►undation• CYTFt other ::D Ni::W >deiifalitio :REP.::- c' 'a `:FPS .. re> 'totect s:s tem NOTE USE:o't't I:FO
RETAINING:WAL L DETACHED:DECKS ::SIGNS' AWNINGS CANOPIES
:::::.:::.:.:..:..:.:
is \ovrcntr.doc (dst) 8/97
1
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST v
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
p¢ BUP '1 ,
8 1755 Date Requested ' 1 a L 0 AM PM BLD 1 1.r --
Location 12.323 6 (P "- /E'`c- Suite gw,
Contact Person Pa1AkL QAA- Ph 3 7 (17 PLM._ _
Contractor Ph • SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: j
Foundation ( cJ p95- FPS
Ftg 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 & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final '
FAIL
ECHANIC
Po am C �
Rough In t.E,
Smoke Dampers
1 -ART FAIL
RICAL
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 Date 9e l /?dpector - Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
_ BUP
,7 �' % Date Requested /. i AM PM BLD
Location � .? _, , . SC! , f!✓' 7 %' Suite d ` 2- J' 3
Contact Person C!_ _��.(_1 i % &A _- Ph / / ; (/
/ / PLM
Contractor Ph SWR
BUILDING Tenant/Owner FAA C1 " 10 S .
Retaining Wall ELR
Footing
::: es: � �( rrn FPS / �� SGN � q'Lo (ti f'
Slab SIT
Post & Beam _ �, � 1;:' : �/' : G'1 _CC / i1 �! ,;
Ext Sheath /Shear �.0 "( P .� C • C�,,. / C L �, �'�
Int Sheath /Shear �1
Framing
Insulation
Drywall Nailing
Fire S p CV,70� 4-17- 79e 6 _ y/ 7/
Fire Sprinkler � _ / C� J CJ / �
Fire Alarm
Susp'd Ceiling •
Roof -
Misc:
Final
PASS PART FAIL
PLUMBING - -
Post & Beam
Under Slab
Top Out
Water Service •
Sanitary Sewer
Rain Drains
Final
AIL
O h i
Post & Beam �' 1 4-1 ":!/-"/
Rough Iri Ct,b w %
as Line 1
S • e Dampe •
fg )' PART FAIL
RICAL
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 for reinspection RE: ] Unable to inspect - no access
• Fire Supply Line ease c /
ADA
Approach /Sidewalk
Other Ignspector e- - " = - Ext
D
Final
PASS PART . FAIL DO NOT REMOVE this inspection record from the job site.