Permit A CITY OF TIGARD MECHANICAL PERMIT
A'41)01' DEVELOPMENT SERVICES PERMIT #: MEC1999 -00167
'�' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/19/99
.4111- PARCEL: 2S103DC-00803
SITE ADDRESS: 13530 SW 115TH AVE
SUBDIVISION: VIRGINIA ACRES ZONING: R -3.5
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 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:
Remarks: Residential mechanical alteration
Owner: FEES
ROBERT MILLS Type By Date Amount Receipt
13530 SW 115TH AVE PRMT BON 4/19/99 $25.00 00- 314666
TIGARD, OR 97223 5PCT BON 4/19/99 $1.75 00- 314666
Total $26.75
Phone: 624 -2343
Contractor:
SUN GLOW
2428 SE 105TH AVE
PORTLAND, OR 97216 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 253 -7789 Final Inspection
Reg #: LIC 00048131
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 -01R1 -0080.
You may obt in copies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: , ) /1i1 Q,{, Permittee Signature: i((4 — tfAd ail
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the nbxt business da
( ) Y p day
Plan Check #
CITY - OF TIGARD RECEIttfilithanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd .-
TIGARD, OR 97223 APR 19 1999 Date to P.E.
(503) 639 -4171, x304 Date to DST
COMMUNITY DEVELOPMENT Print or Type Permit #MCLPIM 'c)( k/
Called
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 -3 S W i iS
Bldg# City/State Zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents 6 iX
Name (or pame of business) 2.) Furnace 100,000 BTU+ 7.50
Owner 0 - )e. -t ' I I.s including ducts & vents
Mailing Address . 3.) Floor Furnace 6.00
135 ' S w 1 � including vent
City/State Zip Phone 4.) Suspended heater, wall heater 6.00
--- IA A4-pi, 0 4- /42i 62 ti-23y3 or floor mounted heater
Name (or me of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
S liVi'rl( to 3 HP; absorb unit to 100K BUT**
City/State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
5 6 :1--- 15-30 HP; absorb unit.5 -1 mil BTU**
Prior to permit Mailing Attdress ,� i� 9.) Boiler or comp, heat pump, air cond. 22.50
o
issuance, a copy ao St- / ,, i 30-50 HP; absorb unit 1- 1.75mi1 BTU*'
of all licenses City /st �r aa zip 7J,2)f� Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if v T / - di- 25 > 50 HP; absorb unit 1.75 mil BTU**
expired in COT Oregon Const. Cont. Board Lic.# Exp. D e 11.) Air handling unit to 10,000 CFM 4.50
database yh'l3I s7 9 I A
Architect Name 12.) Air handling unit 7.50
10,000 CTM+
or Mailing Address 13.) Non - portable evaporate cooler 4.50
Engineer City /State Zip Phone 14.) Vent fan connected to a single duct 3.00
Describe work New 0 Addition 0 Alteratiort)( Repair 0 15.) Ventilation system not included 4.50
to be done Residential Non - residential 0 in appliance permit
Additional Description of work: 16.) Hood served by mechanical exhaust 4.50
17.) Domestic incinerators 7.50
-f1 S o of -,1-1 ( Y■ G� 0'
Existing use of 18.) Commercial or industrial 30.00
building or property S FT- type incinerator
19.) Repair units 4.50
Proposed use of 20.) Wood stove 4.50
building or property 3 1 ,,.,., -
k... 21.) Clothes dryer, etc. 4.50
Type of fuel - oil O natural ga LPG O 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 2.00
given is correct, that I am the owner or authorized agent of
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 *SUBTOTAL + (fJ
p L alt G/' /Z ( 5% SURCHARGE - . ' .
Contact Person tifime Phone PLAN REVIEW 25% OF SUBTOTAL
Required for all commercial permits only. ` .
Jp1 5)1 .f .5"-3 -7---e7 TOTAL ,4„-,:v
*Minimum permit fee is $25 + 5% surcharge
*'Residential A/C requires site plan showing placement of unit.
I:lmechprmt.doc rev 4/15/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 5 AM PM ." BLD
Location I 1 / .S11-‘ AuLed Suite MEC riqq00 1(117
Contact Person in/v c ik Ph z,c ; --- )g 1 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation 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
P: • FAIL
•
Post & Beam
� '.
Smo.e Dampers
;:tri=""lb 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: Am. / [ ] Unable to inspect - no access
ADA r
Other ach /Sidewalk Date Inspect
Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
I
5/30/00 Activities for Case #: MEC1999 -00167
2:01:12 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 4/19/99 BON DONE No Hold BON 4/19/99
MECA008 Create Permit 4/19/99 BON DONE No Hold BON 4/19/99
MECA715 Mechanical lnsp 4/19/99 4/19/99 No Hold BON 4/19/99
MECA799 Final Inspection 4/19/99 4/19/99 5/24/99 TLP PASS No Hold AKJ 5/24/99
MECA060 (F) Issue permit 4/19/99 BON DONE No Hold BON 4/19/99
MECA705 Gas Line Insp 5/24/99 5/24/99 5/24/99 TLP PASS No Hold AKJ 5/24/99
MECA800 Case Finaled 5/24/99 AKJ DONE No Hold AKJ 5/24/99
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