Permit 1 CITY OF TIG A R D MECHANICAL
PERM I C
/0110 — 13125 ; -∎ \ DEVELOPMENT SERVICES DATE ISSUED: O8• MEC97-1Z1321
PARCEL: 2S112CD-01900
SITE ADDRESS...: 15685 SW 79TH AVE EXPIRED
SUBDIVISION • DURHAM ACRES ZONING: R -12
BLOCK LOT :13 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE :SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP :R3 VENTS W/0 AP'PL: 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 < 1OOK BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks: Installing furnace and gas piping
Owner: FEES
ROBERT DREISNER type amount by date recpt
15685 SW 79TH AVE PRMT $ 25.00 B 08/26/97.97 - 298674
TIGARD OR 97224 5PCT $ 1.25 B 08/26/97 97- 298674
Phone #: •
Cont ract or :
FITZPATRICK HEATING & REFRIGTN
77615 SW CHESTNUT STREET
$ 26.25 TOTAL
TIGARD OR 97223
Phone #: 245 -3870
Reg #..: 000523
REG!UIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard'Nunicipal Code, State of Ore. Specialty Codes and all other Misc. Inspect ion
applicable laws. All work will be done in accordance with Final I n s p e c t i o n
approved plans. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
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 / � _
;10promm—
f
Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Chec #
CITY OF TIGARD Mechanical Permit Application Reed By . aN
13125 SW HALL BLVD. Commercial and Residential Date Recd ( 1 - 14 -
TIGARD,,. OR 97223 EX®�c® Date to P.E.
(50363 -4171, x304 AA"�'' CC Permit# IMF- C
Print or Type
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suttee A) Permit Fee -0- -0- 10.00
Address / 57' r S_ (,,// 79
Bidg# City /State Zip 1.) Furnace to 100,000 BTU 6.00 /
including ducts & vents . / (
Name (or name of business) 2.) Furnace 100 BTU+ 7.50
Owner Pd?, CQ 7'� f) 1 .Q S'A,,e-t including ducts & vents
Mailing Address � / 3.) Floor Furnace 6.00
6 s_(,,ir 7 including vent
City/State Zip Phone 4.) Suspended heater, wall heater 6.00
1' 4. t 0 q7 # 2,2 L( �q_j 3 or floor mounted heater
Nam name of business) 5.) Vent not included in appliance permit 3.00
l I Pi) >° Sti
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
/ 5 5. Lif 7 9' to 3 HP; absorb unit to 100K BUT"
City/State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
7-1514-0--,0 a 17 .4( 6 3 9 ' y 3-15 HP; absorb unit to 500K BTU"
.. Contractor N 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to ft 77,97--.2 /C([ //e/7--7,-- " , 15-30 HP; absorb unit.5 -1 mil BTU"
issuance Mailing Ad 9.) Boiler or comp, heat pump, air cond. 22.50
applicant . 76 / S - ,5', (,,L C hie 5T " u. / 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all City /St to Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor T; (2,,� 3 o2 Y5 2 () > 50 HP; absorb unit 1.75 mil BTU"*
license Oreg onst. Cont. on Board Licit Exp. Date 11.) Air handling unit to 10,000 CFM 4.5 -
information 9--(2 33 I / ^ q F �
for COT COT Business Tax or Metro # Exp. 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 duct 3.00
Engineer City/State Zip ( Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration pt Repair O 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Addkional Description of work 17.) Domestic incinerators 7.50
8 efj0 V e- o > t; ((.tr74.4-e -e )= -
- e-57 cL 64 S f,~- 2 Y- F 5 r _ 18.) Commercial or industrial type 30.00
-
r( .(!'�� r e Incinerator
Existing use of 19.) Repair units 4.50
building or property
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 - oil 0 natural gasX LPG 0 electric 0 23.) Gas piping one to four outlets / 2.00 L
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.
Si c - atu - of Owner /Ag- �' Date 'SUBTOTAL
/' �� r 2 ? 5 % SURCHARGE 1 2-
I . tact Person a . e Phone PLAN REVIEW 25% OF SUBTOTAL
.- TOTAL
J7 10e-ti ./;�. i 2'tc, -.
,2
p, � LC
- -
i:\dstlmechpmt.doc (rev 'Minimum permit fee is S25 + 5% surcharge
"Residential NC requires site plan showing placement of unit.
.. CITY OF TIGARD BUILDING INSPECTION DIVISION MST
'''24 -Hour Inspection Line: 639 -4175 . Business Line: 639 -4171 •
BUP
Date Requested .A AM PM BLD .
Location 1 SKS 7 AuE Suite MEC 97 - 66;z
. Contact Person , Y Ph PLM
Contractor of t ZF , v1; Ph 2 .276) SWR
BUILDING s Tenant/Owner ELC
Retaining Wall ELR
Footing Access: •
Foundation , � n �� /)� „ ' 1, Jiv1 it� / jas Qrj FPS
Ftg Drain I l� C%f/I �'7 / l SGN
Crawl Drain Inspection Notes:
-
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing,
Insulation
Drywall Nailing
Firewall I'
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
_ PASS PA FAIL
,MEG
Post & Beam EXPIRED
Rough In
Gas Line •
S I Dampers
- ASS PART FAIL
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 reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Date Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.