Permit 7 ' ,
!
�� CITY � TIGARD
MECHANICAL
DEVELOPMENT PERMIT
~�u��w�n�~�" "�"~~"�" SERVICES
. � PERMIT # �� - 11. /��2��N/M�8@A�.�#�r�QR�72�/ �0D G3��/7/ ^ ^ ^ ^ ^ ^ ^ : MEC96-0352
Blvd., Tigard, ' DATE ISSUED: 10/11/96
PARCEL: 2S111AC-05500
SITE ADDRESS...: 14900 SW 92ND AVE
SUBDIVISION....: LAUNALYNDA PARK ' ZONING: R-4.5
BLOCK..........: LOT.............:23
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/O APPL: 0 VENT SYSTEMS: 1
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 OTHERUNJTS.: 1 ,
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN >=1690K BTU: 0 > 10000 0
Remarks: Gas fireplace insert
Owner: - - - FEES
JOE CORNETT type amount by date recpt
14900 SW 92ND AVE' PRMT $ 25.00 JDA 10/11/96 96-284575
5PCT $ 1.25 JDA 10/11/96 96-284575
TIGARD OR 97224
Phone #: 620-1020
.
Contractor: -- , eX
LUDEMANS INC ~ RED
12675 SW CANYON RD
BEAVERTON OR 97005 -
Phone #: 646-6409 $ 26.25 TOTAL
Reg #..: 51469 •
• . REQUIRED INSPECTIONS
This permit -is issued subject to the regulations: contained in the echanical Insp __
Tigand Municipal Code, State of Uro,•,Specialty Codes'. and all. other- Final Inspection .
applicable laws. All work will be done in accordance with ' . ^ . • ^�'
approved Tins. This permit. will expire-if work is nett started ' • ' ' __' ' ' '
within `18N -days of issuance, or if work. is suspended for me
• than 1vi dayt.
. �
__
___'
Permittee Signature: / �� ___`
/ _
Issued By: ' +�%x��'�_� ____-
° ' Call for inspection' 7'639-4475 ,
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By
1 3125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
7 Print or Type
Called
N�LL96���
0811-1.);( r Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address 1 4goo 5(4 g 2°4:1-
Bldg# City /State Zip B) Supplemental Permit 3.00
'Tina lard.. a 72.2 .
Name (or name of business) 1.) Furnace to 100,000 BTU 6.00
Owner 3 , ,t. Go ►ceT incl. ducts & vents
Mailing Address 11 2.) Furnace 100,000 BTU+ 7.50
t l i c t 0 0 St-4.) c 2 Rd incl. ducts & vents
City/State n c� Zip Phone 3.) Floor Furnace 6.00
t��0'1 t.Z22y ''4020 in cl. vent
Name (aUiame of business) 4.) Suspended heater, wall heater 6.00
r
Sq,v. GLS C(,bo U�. or floor mounted heater
Occupant Mailing Address 5.) Vent not incl. in 3.00
appliance permit
City/State Zip Phone 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorp unit to 100K BTU
Nape 7.) Boiler or comp, heat pump, air cond. 11.00
Li , h S 3-15 HP; absorp unit to 500K BTU
Contractor Mailing Address 8.) Boiler or comp, heat pump, air cond. 15.00
12. 675 C G 0 15-30 HP; absorp unit .5-1 mil BTU
Attach copy of c State 2 Ph one 9. Boiler or comp, heat pump, air cond. ' 22.50
Current Licenses zaae V" t"o t4 30-50 HP; absorp unit 1 -1.75 mil BTU
Oregon Const Cont. Board tic.# Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
S 1 (p _ •- ro > 50 HP; absorp unit 1.75 mil BTU
CC ( COT Business Tax or etro # i Exp. Date 11.) Air handling unit to 4.50
10,000 CFM
Architect Name 12.) Air handling unit 7.50
10,000 CTM +
or Mailing Address 13.) Non portable 4.50
evaporate cooler
Engineer city/State zip Phone 14.) Vent fan connected 3.00 ��
to a single duct t 3. W
Describe work New 0 Addition 0 Alteration Repair 0 15.) Ventilation system not 4.50
to be done Residential 0 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 industrialtype 30.00
building or property incinerator
19.) Repair units 4.50
Proposed use of 20) Woodstove 4.50
building or property 4' �I p , ,�
G4't4t/ti 21) Clothes dryer, etc. 4.50
Type of fuel - oil . nat ral gas LPG 0 electric 0 22) Other units ' 4.50
1 - -�
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
laws.
tie, Co- -1 -6 /19 t3 °r`,o
Signature of Owner /Agent Date QTY.SUBTOTAL _ 60
*SUBTOTAL _
Contact Person Name Phone 5% SURCHARGE I Z
PLAN REVIEW 25% OF SUBTOTAL
TOTAL 2/ 0 2 5-
i:tdst\rnechpmt.doc (rev 7196) *Minimum permit fee is $25 + 5% surcharge 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested L AM PM BLD
Location I g9 OD 92 ' 54&/ , Suite MEC IK0
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR •
Footing
Foundation NOT REQUESTED FPS
Ftg Drain
Crawl Drain FOUND DURING RESEARCH SGN
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post & Beam IA0
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling e /
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�e Dampers
in
PASS 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
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
5 /1 /00 Activities for Case #: MEC96 -00352
1:56:43 PM
. Assigned Hold Updated
Activity Description • Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 10/11/96 JDA PASS JDA 10/11/96
MECA799 Final Inspection JDA 10/11/96
MECA715 Mechanical Insp 10/11/96 JDA 10/11/96
MECA060 (F) Issue permit 10/11/96 JDA PASS JDA 10/11/96
MECA705 Gas Line Insp 10/18/96 TLP PASS TLP 11/7/96 gas line only
MECA750 Misc. Inspection 2/18/00 2/18/00 2/18/00 JMT DONE No Hold JMT 2/18/00 research inspection request
MECA880 Expired by limitation 4/11/00 HAP DONE No Hold AK) 4/11/00
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