Permit CITY OF TIGARD MECHANICAL
, ,e e . DEVELOPMENT SERVICES PERMIT
— All - — 13125 SW Hall Blvd.., Tigard, OR 97223 (503) 639 -4171 PERM I T # ME
DATE ISSUED: 03/11/99 -0098
9
PARCEL: 2S113AD -01900
SITE ADDRESS...: 16640 SW 72ND AVE #B -10
SUBDIVISION • ROSEWOOD ACRE TRACTS ZONING: I –L
BLOCK LOT -009 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 4 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:S2 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP - 0 DOMES. INCIN: 0
:GAS 3 -15 HP . 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP • 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: 2 <= 10000 cfm: 0 GAS OUTLETS.: 6
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Install 2 1'.', BTU furnaces, 4 heaters, and gas piping for TI.
Owner: FEES
PACIFIC REALTY ASSOC type amount by date recpt
15350 SW SEQUOIA PARKWAY PRMT $ 49.00 DLH 03/11/99 99- 313618
SUITE 300 PLCK $ 12.25 DLH 03/11/99 99- 313618
TIGARD OR 97223 SPCT $ 2.45 DLH 03/11/99 99- 313618
Phone #:
Contractor:
PROTEMP ASSOCIATES INC
807 NE COUCH
$ 63.70 TOTAL
PORTLAND OR 97232
Phone #: 233 -6911
Reg #..: 000388
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 laws. All work will be done in accordance with Heating Unt Insp
approved plans. This permit will expire if work is not started Duct Inspect i o n
within 180 days of issuance, or if work is suspended for more S. D. Shut–down
than 180 days. ATTENTION: Oregon law requires you to follow rules Misc. Inspection
adopted by the Oregon Utility Notification Center. Those rules are Final Inspect Inspection
set forth in OAR 952-0014010 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: , _ �,,, , •0O
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check # -3 - ,g, C
CITY OF TIGARD Mechanical Permit Application Rec'd By Z-
13125 SW HALL BLVD. Commercial and Residential Date Rec'd r 9 9
TIGARD, OR 97223 Date to P.E. "
(503) 639 -4171, x304 Date to DST •
Print or Type -'r/ Permit# glee, lei- V
Cal ed 3 -40 -99
Incomplete or illegible applications will not be accepted , o, ,{,, ,,,;�,��
of Development/Project Description t2
/ J .Z.17 - 6e o !list % Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suites A) Permit Fee -0- -0- 10.00
Address �--a -410 Stn/ a.on
Bldg# 7c / State Zip 1.) Fumace to 100,000 BTU 6.00
19 tyd,.be�n 0Q , including duds & vents c /9,00
Name (or name of business) 2.) Fumace 100,000 BTU+ 7.50
Owner / /Fir'_ ,e1A-t9f 4-ss , including ducts & vents
Mailing Address // 3.) Floor Furnace 6.00
15.3-CO SO SeuG /A• Pk r J/ 3U'7j induding vent
City/State Zip Phone 4.) Suspended heater, wall heater 6.00
Pd- YZ/t 97 .2.A y or floor mounted heater y y O e
(or name of business) _ 5.) Vent not included in appliance permit 3.00
/-cam/ S /0.0 - .4,4177�'ie.CONrKILrG/
Occupant M Address 6.) Boiler or comp, heat pump, air cond. 6.00
• gyp s'ai n A/O to 3 HP; absorb unit to 100K BUT" •
C.. e Zip I Phone 7.) Boiler or comp, heat pump, air cond. 11.00
•
� C r •e..4 in C e . 97 •7 4 n - 990 G 3-15 HP; absorb unit to 500K BTU"
Contractor // �� 8.) Boiler or comp, heat pump, air cond. 15.00
RE /V.CtiC - �klc , 15-30 HP; absorb unit5-1 mil BTU"
Prior to permit Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy * ,(/ CC,. j 30-50 HP; absorb unit 1- 1.75mi1 BTU"
of all licenses CA/State Tip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if zdkfD OR g72 . 7i2 233 -69// > 50 HP; absorb unit 1.75 mil BTU"
expired in COT Oregon Cont. Cont. Board t.ic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database 7R•KR4.' _ 5 /`8 • Y9
Architect Name 13.) Non - portable evaporate cooler 4.50
-ce/P //l4l.0 5J/2/E
or M 'ling Address 14.) Vent fan connected to a single dud 3.00
E n inee_i) C State Q . Zip Phone 9 15.) Ventilation system not included in 4.50
/ / rn c,Ttsa/l� C/.P 90 1�tay� �" appliance permit
Describe work New 0 Addition-1Si Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non- residentialike
Additional Description of work: 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property /��CA.r.i. i P20i.g eci
l /��
1 G . 20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - 011 natural gas' LPG 0 electric 0 23.) Gas piping one to four outlets 0 I ■ 2.00 fob _
n L S
I hereby acknowledge that I have read this application, that the 24.) More than 4-per outlets (each) .50 ® � I �y
information given is correct, that 1 am the owner or authorized agent of 1 I
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
taws. N
Signature of Owner /Agent Date 'SUBTOTAL I J
��' 5% SURCHARGE
C tact Perso ame Phone PLAN REVIEW 25% OF SUBTOTAL 4
. 2 la
TOTAL n3, C
, mr Li 233 -69 //
i:4nechpmt.doc (rev 9 'Minimum permit fee is $25 + 5% surcharge / /1/
"Residential A/C requires site plan showing placement of unit /
(913'
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 3-3q-99 AM PM BLD
Location L (D (O v i 2 rOL Suite MEC 9 1 (ZO
Contact Person < Ph 233 "Coq /1 PLM
Contractor PYy 1 0 Ph SWR
BUILDING j'ewner pre 6 . 4-1'11.44Corj'leQ ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: col ,�y�
Slab / I U U 1 't7mi2d . 1' SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall - R Q / A eq T<<� ---
Fire Sprinkler /
Fire Alarm -
Susp'd Ceiling ( / 2s.' G 7 v P tj Al / /
Roof
Misc:
Final
PASS PART FAIL
PLUMBING / ?`' j 77 e L - 677 / i�
Post & Beam
Under Slab K2 5 - 77/21/ e r-o /t c/ S c J "e/z- T
Top Out
Water Service 0F / f" d ap l',.i, %T cop-1,k f
Sanitary Sewer
Rain Drains
Final
P • SS PART FAIL
. _ , jj 4 / / . /C e on - /eT�
P,_.iiid m / ca d �f
040 e Dampers
e t'
�•7�1 PART FAIL co-reel--
ELECTRICAL
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
Fire Supply Line [ ] Please call for reinspectio RE: [ 1 Unable to inspect - no access
ADA --�
Approach/Sidewalk
�/
Date 3 /' / Ins i, -"� Ext
Other
Final
PASS PART FAIL DO NOT RE OVE this inspection record from the job site.