Permit CITY TIGARD MECHANICAL PERMIT
I I DEVELOPMENT SERVICES PERMIT #: MEC1999-00448
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/19/1999
PARCEL: 2S116AD -29900
SITE ADDRESS: 16880 SW 126TH AVE
SUBDIVISION: KING CITY NO. 10 ZONING:
BLOCK: 13 LOT: OOA JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 1 <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install 1 gas furnace to 100,000 BTU including ducts and vents and
1 gas furnance 100,000 BTU+ including ducts and vents.
Owner: FEES
KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt
15245 SW 116TH PRMT KJP 10/19/19. $50.00 KING CITY
KING CITY, OR 97223 5PCT KJP 10/19/19. $4.00 KING CITY
Total $54.00
Phone:
Contractor:
MILWAUKIE HEATING + COOLING
9961A HWY 212
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 557 -5562 Heating Unt Insp
Reg #: LIC 104102 Final Inspection
ORIGINAL
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 -918 .0
Issue By: Permittee Signature: GL
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
T - 19 - 99 TUE 01:01 PM City of King City FAX:503 639 3771 PAGE 2
ITY OF TIGARD Mechanical Permit Application
Plan Check # •
• p Rec'd By
13125 SW HALL BLVD. c ommercial and. Residential Date Recd 10 - i - qcl
TIGARD, OR 97223 ,q ` � r \ � Date to P.E.
(503) 639 -4171, x304 i- `1 r Jv '' ' Date to DST 10 -Q`7
Permit # / EGlyyy - 0 0 Y 'i 8
� P rin t or Type Called
Incomplete or illegible applications will not be accepted
Name of bevelapment/Proiect Description
Table 1A Mechanical Code Oty Price Amt -
Job street Address suiten A) Permit Fee 16.00
1) Furnace to 100,000 BTU
Address « $S� c5 L3 Y I Z 1 Including duds &vents see footnote 1,2 < . .1 ., 9.65 •
Bldg# City /state zip. 2) Furnace 100,000 BTU+
K1 v e including ducts & vents see footnote 1,2 1 12.00
Name (or name of business) 3) Floor Furnace
Owner K 1 ti)0( � f" 4 u4 45500 , including vent see footnote 1,2 . . 9.65 ,
Mailing address 1 4) Suspended heater, wall heater
titi+ or. floor. mounted heater see footnote 1,2 9.65
j
154-4 S . I iL 5) vent not included in appliance permit . • 4.75
CIty/Slate zip Phone Check all that apply: Boiler ' Heat Air
teCf.Cl t. t Gr, Q?ZZ�f (.034� S For Items 6-10, see or Pump Cond Qty Price Amt
Name ( name of usiness) footnotes 1,2 Comp
6) <3HP;absorb' unit to
, 1OOK BTU 9.65
Occupant Mailing Address - 7) 315 HP;absorb unit
• 100k to 500k BTU 17.65
city/state . zip I Phone 8),15 -30 HP; absorb
unit .5-1 mil BTU 24.15 •
Contractor Na'r1e 9) 30-50 HP; absorb
1, unit 1 -1,75 mil BTU 36.00
jL ,a k; e -,, IfS 1 0) >5OHP; absorb unit
tn
Prior to permit g address -- � ?1.75 mil BTU 60.15
issuance, a copy 11 Air handling unit to 10,000 CFM
of all licenses Cltyisis e p ✓ Z�� � Ph ^ � on -r e �� v, � 7.00
are required if /t IC 9 C.�'.� . 3 /�J3 12) A ir h andling unit 10,000 CFM+
expired in COT Oregon Conat. Cont. Board. Llc.# �/� Exp. Datet 11.85
database /6 y /l,_ 13) Non - ponable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single' dud .
M a iling Address • 4
or 15) Ventlation system not included in
• appliance permit . 7.00
Engineer clty/State Zip Ph 16) Hood served by mechanical exhaust .
7 -0o
Describe work to be done: 17) Domestic incinerators
12.00
New 0 Repair 0 Replace with like kind: Ye No 0 18) Commercial or Industrial type incinerator . y
Residential Commercial 0 /' 48.25
• 19) Repair units , . .
Additional information or description of work: . - 8.40
20) Wood stove/gas FP /other units/clothe dryer/etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas talcs. See footnote 1. • , • 3.75
Type of fuel: oil 0 natural gas ilj LPG 0 electric 0 22) More than 4 -per outlet (each) 75
Minimum Permit Fee $50.00 SUBTOTAL H 50.00
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE y L,r ( ,
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL ,,sl r ns,
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only lust4t
TOTAL !r ' , .0 "
. ,1 �x +, �r ., 5z( -CO.
Sign -t • w • • - Date
/! � Other Inspections and Fees:
/ % •.... y �Vyofr , 1. Inspections outside of normal business hours (mininum charge -two
• ntact ` - - • n e Phone hours) $60.00 per hour
- 2. Inspections for which no fee is specifically Indicated (minimum
i) - e ez-2 i s9t ..1---,5--2..s5-42.. charge -half hour) $50.00 per hour
Foonotes for commercial projects only 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and:pressure. plans (minimum charge - one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical 'State Contractor Boiler Certification required
units.
"Residential NC requires site plan showing placement of unit
O nechperm.doc rev 7/19/99
t
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested /0/ 4? / 7 AM PM BLD
Location /( /?(Q Suite MEC (q T � vv ���
Contact Person JO�.� Ph .57 � PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access' FPS
a / � �
Foundation t i yu< „ / c V rlQ t
Ftg Drain l� ((/� '
SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
R Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
Z i =1 . - FAIL
Post & Beam
Smoke Dampers
Fin
(P 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
Other oach /Sidewalk Date Inspector 9/7 Ext
Final
PASS PART FAIL NOT REMOVE this inspection record from the job site..