Permit ' / CITY OF T MECHANICAL
' ~
DEVELOPMENT SERVICES
!IF .�� PERMIT # : MEC97 0101
ass�- ���� ��/���N/M�0�hxi Tigard, �U����/7l ^ ^ " ^ ^ ^ ^ -
- � � DATE ISSUED: 05/13/97
PARCEL: 2S113AB-00800
SITE ADDRESS...: 15995 SW 74TH AVE
SUBDIVISION - ZONING: I-P
BLOCK..........: LOT.............: JURISDICTION: TIG
_ _
CLASS OF WORK..:ALT FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE :COM UNIT HEATERS..: 2 VENT FANS...: 4
OCCUPANCY GRP..:B VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES........: 1 BOILERS/COMPRESSORS HOODS ^ 0
FUEL TYPES 0-3 HP : 2 DOMES. INCIN: 0 '
:GAS 3-15 HP : 4 COML. INCIN: 0
MAX INPUT: 1000000 BTU 15-30 HP....: 0 REPAIR UNITS: 0
FIRE DAMPERS?..: Y 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 GAS OUTLETS.: 1
FURN >=100K BTU: 0 > 10000 cfm: 0
Remarks: Mechanical TI ,
Owner: - - ----- FEES
JOHN DUNCAN type amount by date recpt
16055 SW 74TH PRMT $ 92.00 JSD 05/13/97 97-294492
TIGARD OR 97224 PLCK $ 23.00 JSD 05/13/97 97-294492
5PCT $ 4.60 JSD 05/13/97 97-294492
Phone #:
Contractor:
OWNER •
.
Phone #: $ 119.60 TOTAL
Reg #..:
REQUIRED INSPECTIONS
This permit is issued subject to the reUolatimo'cnotaimed in the Gas. Line Insp __
Tigar6llumicipal 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 Fire Damper Insp .
withio18W.`days of'. issuance, .;or if workiis suspended for more • ' Final. Inspection
than , •1:. days., —
_____ _
N�� --- -
Permittee Signatur � �� �N� �� � _ ---- - -- -' ----- ____ ____^
~° ~-- ����c= .. --' ----'
Issued _- __-_---'-- ------� -- -- '� —�w�
Call for inspection - 639-4175
I ' Plan Check # u ) - .) r
CITY OF TIGARD Mechanical Permit Application Recd By ' d
13125 SW HALL BLVD. Commercial and Residential Date Recd -I `6 -' 7
TIGARD, OR 97223 (40P1 Date to P.E. -13
(503) 639 -4171, x304 Date to DST �
Permit # M.( 87-0(01
Print or Type .�'
Incomplete or illegible applications will not be accepted Called I 1
Name of Dev, IopmenvPro)ect Description
. - T e 1 ( , r ■F - 1 1 4 t p,e - - Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address l S' S) • 14 too 'Leo ID .
Bldga 1 city/State Zip B) Supplemental Permit 3.00
16 ayfi 47ZZ'(
Name (or name of business) 1.) Furnace to 100,000 BTU 6.00
Owner LQ�rn S incl. ducts & vents
Mailing Address 2.) Furnace 100,000 BTU + 7.50
6QSS SL CU U incl. ducts & vents
City /State Zip Phone 3.) Floor Furnace 6.00
t t 6 cur - Oc - incl. vent
amN (or n f busine s)--- / 4.) Suspended heater, wall heater 6.00
J • LA ,c1- til ?1k (rh'(Jy or floor mounted heater v I Z/
Occupant Maa�iliin� Address
5.) Vent not incl. in 3.00
1 q c , co Y Z 4 appliance permit
State Zip 1 Phone 6.) Boiler or comp, heat pump, air cond. 6.00
( l.6 Of ZZ - to 3 HP; absorp unit to 100K BTU 17 i2 V.
Name 7.) Boiler or comp, heat pump air cond. ,�1� ( 11.00 4, f /
$/ 5 3-15 HP; absorp unit to 500K BTU - d , `[
Contractor Mailing Address / 8.) Boiler or comp, heat pump, air cond. 15.00
1 6 0 S % , 5 4 . 1 ) 1 1 4 15 -30 HP: absorp unit .5 -1 mil BTU
(Prior to . City /State Zip Phone , ' 9.) Boiler or comp, heat pump, air cond. 22.50
�(,
issuance a copy , . p 6gy - dr 5 � � 30-50 HP; absorp unit 1 -1.75 mil BTU
of all licenses are Oregon Const. Cont. Board Lic.# Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
required if ' > 50 HP; absorp unit 1.75 mil BTU
expired in C.O.T COT Business Tax or Metro 4 Exp. Date 11.) Air handling unit to 4.50
data base) 10,000 CFM
Architect Name , - ,. t 12.) Air handling unit 7.50
+. r, G t, n, ory. LVs. *t tX' 10,000 CTM +
or Mailin�� / dress r 13.) Non portable 4.50
iO Z+S 66/A6 St' evaporate cooler
Engineer City/srgte Zip Phone A ,,/, 14.) Vent fan connected 3.00 /
T t (T _`di 4P • Wfiv to a single duct / i
Describe work New 0 Addition 0 Alteration 0 Repair 0 15.) Ventilation system not 4.50
to be done Residential At Non - residential 0 included in appliance permit
Additional Description of work 16.) Hood served by mechanical exhaust 4.50
17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industriaitype 30.00
building or property incinerator
19.) Repair units 4.50
Proposed use of r t 20) Woodstove 4.50
building or property (.,3 4 �. AI.A...C--i'‘J
21) Clothes dryer, etc. 4.50
Type of fuel - oil 0 natural gas I) LPG 0 electric 0 22) Other units 4.50
I hereby acknowledge that I have read this application, that the 23) Gas piping one to four outlets / 2.00 /)
information given is correct, that I am the owner or authorized agent of
the owner; that plans submitted are in compliance with Oregon State 24) More than 4 -per outlet (each) .50
la
kLA„..40.....____ 3/7 Si a of Owner /Agent e QTY.SUBTOTAL
4104" [' /GG(� r'Y �� `" Col 'SUBTOTA C 1 V
Contact Person Name Phone 5% SURCHARGE Gf"`
PLAN REVIEW 25% OF SUBTOTAL 212/
TOTAL
--i------ (171-4;
i:\dstlmechpmt.doc (rev 7/96) S)(/ A T 'Minimum permit fee is 525 + 5% surcharge
. Od P
/ ��
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 10 .1.
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested cam/ 3 AM PM BLD
Location / 5 7 T t Suite MEC 9/ 01 n!
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: /�� /,/)/J T
Slab -x-1 (1 r V ( dJ (.C/7 w. SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: jti 5/)/
Final
Final 07 -- /," •
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab / f � s v '-
Top Out
Water Service
Sanitary Sewer
Rain Drains 0,15'e
Final
FAIL
7
Beam
Rou n
Gas Line
Smoke Dampers
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
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach/Sidewalk
Other Date /� Q Inspector Ext
Other .1
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.