Permit CITY OF T 1+1ECHAN I CAL
PERMIT
14-414.6\ DEVELOPMENT SERVICES
DATE 03/2E 9-0118
PARCEL: 15134DB -04700
SITE ADDRESS...: 11100 SW 109TH AVE
SUBDIVISION....: CARNAHANS ADDITION ZONING: R -4.5
BLOCK LOT :009 JURISDICTION: TIG
CLASS OF WORK..:OTR 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: 0
STORIES ° 0 BOILERS /COMPRESSORS HOODS ° 0
FUEL TYPES 0 -3 HP....: 1 DOMES. INC I N: 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.. a: 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: 1 ? 10000 cfm: 0
Remarks : Installaton of gas furnace, a/c & gas piping. A/C placement must
comply with standard setbacks.
Owner: FEES
MICHAEL FLORA type amount by date recpt
11100 SW 109TH PRMT $ 25.50 DEB 03/22/99 99- 313876
TIGARD OR 97223 SPCT $ 1.27 DEB 03/22/99 99- 313876
Phone #:
Contractor:
ALL TEMP PROFESSIONAL
8230 SE 72N ST
26.77 TOTAL
PORTLAND OR 97206
Phone #:
Reg #..: 000585
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 Cooling Unt Insp
within 180 days of issuance, or if work is suspended for more Misc. Inspection
than 180 days. ATTENTION: Oregon law requires you to follow rules Final Inspection
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.
Iss�_ By: s ' Permittee Signature: Aff
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
11/23/98 IRON 11:48 FAX 503 598 1960 CITY OF•TIGARD ej 002
• Plan Chi -
CITY OF TIGARD Mechanical Permit Application Recd B i_
13125 SW HALL BLVD. Commercial and :Residential Date Rec'd -
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 ' � : Date to DST
Print or T ype Permit #
•
Incomplete or illegible applications will not be accepted called
Name of Development/Project Description
• Tatife1A Mechanical Code Qt • Price Amt
res
Job ' Street Add Suite# A) . ri tit Fee 0 4 4 ' 10.00
1) (...mace to 100,000 BTU
•
Address ii top 1 S ta It}tiiding ducts 8 vents
dg# State Zip 2)' FAnace 100,000 BTU+ ,
t I & q12
iM�luding ducts & vents ' ' `,'' ` • 7.50 '7.5)
Name (or name of business) . 3) .' F,I, or Furnace '
"ing vent 6.00
Owner fI^ �. l3Yt�.
jliciud
l�'► `�� 4 ) ; SU,spended heater, wall heater •
Mailing Address '
�^ ' mounted heater ': -6.00
' 1I nni� l ' l r ` ,��t . 5) , Vent not included in appliance permit
sot/State Zip Phone 3.00
A� 417 .Y1 j .- 1 CHECK ALL • . " `Boiler Heat •Air.•
NamE ( or nant� o business) 1 I 1 THAT',APPLY: or Pump Cond Qty' Price '
�J �,,�,,n , Comp
• 0. - a 4 ) O U'C. - 6) <3HP;absorb unit to ' / / , /
Occupant Mailing Address • 100Ie BTU v ' ' • • . ' 6.00 W
7) 3 -15 HP;absorb unit
City /State Zip I Phone 100k to 500k BTU • • . • 11.00
8) 15 -30 HP; absorb
unit .5 -1 mil BTU 15.00
Contractor Name • 11 `> 9) 30 -50 HP; absorb
ma 1. n unit 1. -1.75 mil BTU _22.50
Prior to permit 't fajli Add re s e.... , t _ '7 AIL p 10 >5OHP; absorb unit
issuance, a copy 7 ll 7s - 1 Sri >1.75 mil BTU . 37.50
of all licenses / e � �Zi ^ P. op�j 11) Air handling unit to 10,000 CFM
are required if - • ,t l a� L�(J�' � '1� l 1 4.50
expired in COT Oreg n Ci t .r e nt. Board Lic.# 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 /'r 3 "00
15) Ventilation system not included in
Engineer City /State Zip I Phone appliance permit 4.50
Poten. 16) Hood served by mechanical exhaust
Describe work to be done: ins Q, e}j -- ` 4.50
17) Domestic incinerators NewrPl / J�"'`" Repair 0 Replace with like kind: Yes 0 No O 7.50
Residential Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units •
4.50
20) Wood stove
4.50
21) Clothes dryer, etc.
4.50 _
Type of fuel: oil 0 natural gas /PG 0 , electric O 22) Other units .
_ 4.50
I hereby acknowledge that I have read this application, that the information . 23) Gas piping one to four outlets ' /
given is correct, that I am the owner or authorized agent of 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
•
Signature of Owner /Agent - • Date ` , ' 7 . 1,1.70 Minimum Permit Fee $25.00 SUBTOTAL ", I .0 _ " I L�i i .. � i 1 La Z : °r ` "_ r, t v i r 5 % SURCHARGE t k '
�w
on Person Name t Phone - PLAN REVIEW 25% OF SUBTOTAL _, :s -41,Y ` ,1 = E ' ,
. 1 l Required for ALL commercial permits only :s tj. .
�C �S 1
/ 0 ' ��l b 1Q54 1 l 1 t ,`i i z TOTAL n t'lt.`..! ht t
*State Contractor Boiler Certification required �
• "Residential A/C requires site plan showing placement of unit !!'
171-6 Ste,
_ • _
31'
•
S • . . ba .
4
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
c BUP
Date Requested q-z 2- tq AM x PM BLD
Location I f I 00 1 Ol t /€, Suite MEC (79 — 0/1 2
Contact Person V k 2 � Ph (0 't fit PLM
Contractor , l! — 1- ? /'vtr Ph SWR
BUILDING Tenant/ ELC
Retaining Wall ELR
Footing Access: / �
Foundation �,, f — (1 {f06 FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
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
‘
Post & Beam
Rough In
Gas Line
Smoke Dampers
ASS PART FAIL
EL TRICAL
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 �j
Opheoach /Sidewalk Date ` ` DL R Inspector �� \ Ext
• Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
6/19/00 Activities for Case #: MEC99 -00118 .
1:48:30 PM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 3/22/99 DEB RECD DST 3/22/99
MECA008 Create Permit 3/22/99 DEB DONE DST 3/22/99
MECA799 Final Inspection 4/26/99 RC PASS AKJ 4/26/99
MECA705 Gas Line Insp 3/22/99 DST 3/22/99
MECA715 Mechanical Insp 3/22/99 4/7/99 RC FAIL AKJ 4/7/99 Gas pipe needs to be
supported at unit
MECA725 Heating Unt Insp 3/22/99 DST 3/22/99
MECA730 Cooling Unt Insp 3/22/99 DST 3/22/99
MECA750 Misc. Inspection 3/22/99 DST 3/22/99
MECA060 (F) Issue permit 3/22/99 DEB DONE DST 3/22/99
MECA800 Case Finaled 4/26/99 AKJ DONE No Hold AKJ 4/26/99
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