Permit CITY TIGARD MECHANICAL PERMIT
n I DEVELOPMENT SERVICES PERMIT #: MEC1999 -00315
°°�' .�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/23/99
PARCEL: 1S133DD-14800
SITE ADDRESS: 11787 SW 128TH AVE
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 ZONING: R -4.5
BLOCK: LOT: 185 JURISDICTION: TIG
CLASS OF WORK: ADD 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: 1 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Exterior A/C unit. Unit must not encroach into 5' side or rear yard setback.
Owner: FEES
AMY SHAH Type By Date Amount Receipt
11787 SW 128TH AVE PRMT BON 7/23/99 $50.00 99- 317111
TIGARD, OR 97223 5PCT BON 7/23/99 $3.50 99- 317111
Phone: 503-590-6228 Total $53.50
Contractor:
SKY HEATING + AIR CONDITIONING
1637 SE NEHALEM
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Misc. Inspection
Phone: 235 -9083 Final Inspection
Reg #: LIC 00050244
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 obta copies of these rules or direct questions to OUNC by .alling(503)246-9189.
(( )) -
Issue By: ` , MIA ,441 Permittee Signature: 1 i ,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busi • - s day
,
' CITY OF TIGARD Mechanical Permit Application Recd By „D 1,\
13125SW HALL BLVD. Commercial and Residential Date Recd 77, -
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST /
Print or Type Permit# 11F-C-- I 1 �,
05i 7I - Z Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address � r (/��{ j�, �py� Suite# A) Permit Fee � a. v a ' I. 16.00
Address l( I re O 15VV 1 �i' NMI() w/ 1) Furnace to 100,000 BTU
Bldg# City /State Zip including ducts & vents see footnote 1,2 9.65
2) Furnace 100,000 BTU+
- including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner L4tt,.'1 including vent see footnote 1,2 9.65
Mailing A ess 4) Suspended heater, wall heater
Ira c i Q� �oy�� },o _ or floor mounted heater see footnote 1,2 9.65
v (� ► tVL� Wv 5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
ti g . r d (1.1 4,23 516-40).2s, p For items 6 -10, see I or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 I Comp ** I
� n 6) <3HP;absorb unit to a
' `� 100K BTU I l 9.65 1 .(6
Occupant Mailing Address 7) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Contractor
9) 30 -50 HP; absorb
�p� Q Inc_ unit 1 -1.75 mil BTU 36.00
/ Name
t lla-1 r 11,9 `t Mc I c 10 >50HP; absorb unit
Prior to permit fl a , i , l in 7, � 7 Are
dds pr�/� >1.75 mil BTU 60.15
issuance, a copy l(�✓ 1 � e / , 11 Air handling unit to 10,000 CFM
of all licenses itY /Ste e , J , l P one 7.00
are required if �� Q �� 1 2) Air handling unit 10,000 CFM+
expired in COT Oregon cons. cont. Board Lic.# Exp. Dote _ - 11.75
database F :3( I 0 l (QL - i3) Non - portable evaporate c;,oier
Architect Name _ 7.00
ilia" 14) Vent fan connected to a single duct
M ailinn-e[Address 4.75
Or 15) Ventilation system not included in
appliance permit 7.00
Engineer city /State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
12.00
New Repair 0 Replace with like kind: Yes 0 No O 18) Commercial or industrial type incinerator
Resit
New)/
Commercial 0 • 48.25
19) Repair units
Additional information or description of work: 8.40
tr i i t-n 1 \. n �1 C A ( „ r - ytcr 20) Wood stove /gas FP/other units /clothe dryer /etc.
�JLAA ( (J 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 0 LPG 0 electric O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL Aft* ' , , , AMVOM 50 ,(1.7
I hereby acknowledge that I have read this application, that the information 7% SURCHARGE 360
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL y
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only ` : ' �, ', �'
TOTAL
Signature of Owner /Agent Date ' . ,. ° /
e 2 92 ,4 -t - it-- 7 f 3J U
C l 1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name Phone hours) $50.00 per hour
C...f9
iLare � 2 e -g 2. Inspections for which no fee is specifically indicated (minimum
I �c o(, U 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
units. *State Contractor Boiler Certification required
* *Residential NC requires site plan showing placement of unit
I:\rnechperm.doc rev 02/4/99
1. •
11'1 5w age' k fcrwo
- 08card, et
•
• N�
3W 1 4 21 ' ►'�r�cre�
41401
HEATING & AIR CONDITIONING
+r o+ rr P.I.+1.nlnm • Pnrtlnnrl OR 97202 • (503) 235-9083
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
3:00 D r BUP
Date Requested Si q/00 AM PM > BLD
Location I I 1¶ 1 2_% ,/ l ( Suite G MEC lg.? C - C ) O; r/ 5
�
Contact Person r / CCA Ph Z . S - ! d �( PLM
Contractor Ph SWR ('
BUILDING Tenant/Owner ELC 1919 " ° °11 Sd
Retaining Wall ELR
Footing Access:
Foundation / FPS -- CUO r ld9Za Ftg Drain ( SGN
Crawl Drain Inspection Notes: ,� /�
Slab t;) lily w l I.01 I I b- Iiirou - SIT
Post & Beam
Ext Sheath /Shear ate 3'00-
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
(AItCHANICAL)
p a, Bearrr
Rough In
Gas Line
Smoke Dampers
- ART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
PART FAIL
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 q(40
O t he oach /Sidewalk Date 0 Inspector 7 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.