Permit C ITY OF TIGARD MECHANICAL PERMIT
I ra DEVELOPMENT SERVICES PERMIT #: MEC2000 -00390
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/28/00
PARCEL: 1 S134DB -04600
SITE ADDRESS: 11080 SW 109TH AVE
SUBDIVISION: CARNAHANS ADDITION ZONING: R -4.5
BLOCK: LOT: 008 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: New gas furnace
Owner: FEES
MURRAY, TONYA J Type By Date Amount Receipt
27550 S PELICAN CT PRMT CTR 9/28/00 $72.50 2720000000
CANBY, OR 97013 5PCT CTR 9/28/00 $5.80 2720000000
Total $78.30
Phone:
Contractor:
ENERGY MASTERS HEATING + A/C
7470 SW 76TH
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 244 -8880 Mechanical Insp
Reg #: LIC 58556 Duct Inspection
PLM 26 -476PB Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with 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 in 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 -9189.
Issue By: Permittee Signature: — Y) �l /i 1
Call (50 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Check #
. CITY OF TIGARD Mechanical Permit Application Recd
13125 SW HALL BLVD. Commercial and Residential Date Recd J z ( C�
TIGARD, OR 97223 -'tom Date to P.E.
(503) 639 -4171, x304 Print or Type Date to DST
Incomplete or illegible applications will not be accepted Pemiit ,;24 J - o�39d
Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Total
Job Street Address / q ` Suite # 1) Furnace to 100,000 BTU
Address 1I DE SVJ i v l including ducts & vents ' 14.00 .QD
!-� 2) Furnace 100,000 BTU+
Bldg# City/State CA._ including ducts & vents 17.40
Tl °72 -7 3) Floor Furnace
Nye (or name of businels) including vent 14.00
of
Owner I jv� 1 n Y A� 4) Suspended heater, wall heater
or floor Mailing Ad s 1 bet floor mounted heater r 14.00
tOgt s l V ` 5) Vent not included in appliance permit 6.80
City /State / Zip Phone
Q le 27 z-644 Repair units 12.15
Check all that apply: *Boiler Heat Air
Na (or name of business) For items 7 -10, see or Pump Cond Qty Price Total
footnotes 1,2 Comp -
Occupant Mailing Address 7) <3HP; absorb unit to
100K BTU 14.00
City /State Zip Phone 8) 3 -15 HP; absorb unit
100k to 500k BTU 25.60
9) 15 -30 HP; absorb
Contractor Name unit .5 -1 mil BTU 35.00
'--i4P�
- tl'�/ l ,te< r 10) 30 -50 HP; absorb
Prior to permit Mailing Address 1 unit 1 -1.75 mil BTU 52.20
issuance, a - 74-70 1 1(o`f -D� 11) >50HP; absorb unit >1.75 mil BTU
copy 87.20
of all licenses I NC / n e r7 Z Z Phone � ! 12) Air handling unit to 10,000 CFM 10.00
are required if I' i CriJ (� l s
expired in COT Oregon Const. Co_ nt. Bo rd t.ic.# Exp. gate / r\ 13) Air handling unit 10,000 CFM+
database 5 0 � C (J 17.20
Architect Name 14) Non - portable evaporate cooler
10.00
15) Vent fan connected to a single duct
Or Mailing Address 6.80
16) Ventilation system not included in
Engineer City /State Zip . Phone appliance permit 10.00
17) Hood served by mechanical exhaust
10.00
Describe work to be done:
_ 18) Domestic incinerators
New 0 ^R� pair 0 Replace with like kind: Yea No O 17.40
Residenti�(1)p Commercial 0 Modification 0 19) Commercial or industrial type incinerator
Additional inf(((ormation or description of work: 69.95
20) Other units, including wood stoves
10.00
NOTE: For Commercial projects only; Units over 400 lbs., located on the 21) Gas piping one to four outlets 1
roof, require structural talcs. prepa d yaicensed engineer. 5.40 �v
Type of fuel: oil 0 natural gas LPG 0 electric 0 22) More than 4 -per outlet (each)
1.00 1
Minimum Permit Fee $72.50 SUBTOTAL * '72.5-0
I hereby acknowledge that I have read this application, that the o
information given is correct, that I am the owner or authorized agent of 8 /o SURCHARGE
the ow er, that plans submitted ar mpliance with Oregon State .-
REVIEW 25% OF SUBTOTAL a .4
la s. JJ __ - 2 0 Required for ALL commercial permits only
Signa
1�. gna ure of w e ge It Date TOTAL y -, �j'
►
1 . )✓\ t I - Ce 0
-i- / Other Inspections and Fees:
J �� '6 t J 1. Inspections outside of normal business hours (minimum charge -two hours)
Contact Person Name Phone $72.50 per hour
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
Footnotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to plans (minimum
1. Provide full schematic of existing and proposed gas line and pressure. charge-one-half hour) $72.50 per hour
2. Provide drawings to scale showing existing and proposed mechanical 'State Contractor Boiler Certification required
units. **Residential A/C requires site plan showing placement of unit
IAdsts\forms\rnechperm_rev.doc 9/8/00
CITY,OF TIGARD BUILDING INSPECTION DIVISION MST
24 =Hour Inspection Line: 639 -4175 Business Line: 639 -4171
UP
/ Date Requested AM 1 /7 Y P M BLD
Location // U S 4✓ /U 9 Suite EC vG 3f U
Contact Person Ph - "' 9 o v PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: � / SGN
Slab to SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall iV
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 PART FAIL
(MECHANIg5B
Posf &Meam
Rough I 4/4„1/4 (Gas L i
Smoke Dampers
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 t U/3 / U u Inspector �� cJ _ l
Other Date Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
_ a
M
BUP - Building Permit ELC - Electrical Permit
4 Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing .4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing ---�
MFG - Structure set -up (i ii Mechanical Permit
Insulation
-4 Inspection Description Date Passed By
Drywall nailing
Post/beam mechanical
Suspended ceiling Gas line
•
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final
Smoke detector
Fireproofing Lab Final Mechanical final /0/3 /0 G kti3
Structural observation
Final inspection
PLM - Plumbing Permit
4 Inspection Description Date Passed By
BUP — Fire Protection System Permit _ Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS
CITY T I G A R D MECHANICAL PERMIT
014, DEVELOPMENT SERVICES PERMIT #: MEC2000 -00390
,411,1. - 11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/28/00
PARCEL: 1 S134DB -04600
SITE ADDRESS: 11080 SW 109TH AVE
SUBDIVISION: CARNAHANS ADDITION ZONING: R -4.5
BLOCK: LOT: 008 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: New gas furnace
Owner: FEES
MURRAY, TONYA J Type By Date Amount Receipt
27550 S PELICAN CT PRMT CTR 9/28/00 $72.50 2720000000
CANBY, OR 97013 5PCT CTR 9/28/00 $5.80 2720000000
Total $78.30
Phone:
Contractor:
ENERGY MASTERS HEATING + NC
7470 SW 76TH
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 244 -8880 Mechanical Insp
Reg #: LIC 58556 Duct Inspection
PLM 26 -476PB Final Inspection
4
S oN,
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended UV
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in 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 -9189.
Issue By: �1 Permittee Signature: �'7)
Call (50 639 -4175 by 7 :00 P.M. for inspections needed the next business day