Permit CITY OF T SERVICES MECHAN I GAL
gym, DEVEL PERMIT
� � PERMIT # MEC99 -0140
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04 / 01 / 99
PARCEL: 2S110DB -90931
SITE ADDRESS...: 15437 SW 114TH CT #93
SUBDIVISION ° FOUNTAINS AT SUMMERFIELD CONDO ZONING: R -25
BLOCK LOT °093 JURISDICTION: TIG
CLASS OF WORK..:ALT 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 ° 0 DOMES. INCIN: 0
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..: 1
GAS PRESSURE...: 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 Y =100K BTU: 0 ) 10000 cfm: 0
Remarks : Install a gas insert and gas piping.
Owner: - - - -- - FEES --
GEORGE PICKETT type amount by date recpt
15437 SW- 114TH CT PRMT $ 25.00 GEO 04/01/99 99- . 314168
#93 5PCT $ 1.25 GEO 04/01/99 99- 314168
TIGARD OR 97224
Phone #: 624 -8292
Contractor:
LUDEMAN'S FIREPLACE & PATIO
12675 SW BEAVERDAM RD
26.25 TOTAL
BEAVERTON OR 97005 -2129
Phone #:'646 -6409
Reg #..: 51469
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 Final Inspection
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 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.
Issue By: �.4( 7 Permittee Signature: ��,,��/ /
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
• Print or Type Permit # PF(r' 9g-6)90
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
P , e <&77--- Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee t :` 10.00
Address / .9 4 7 '7 //U 3 1) Furnace to 100,000 BTU
induding ducts & vents 6.00
Bidg# City/State Zip 2) Furnace 100,000 BTU+
including ducts & vents 7.50
Name (or name of busin t 3) Floor Furnace
v
C i �Y � r V c (0 including vent 6.00
4) Suspended heater, wall heater
Ma ing Addre 1 /` • or floor mounted heater 6.00 (4.•
7 4 ) 1/ �� / f r 93 5) Vent not included in appliance permit
C4 e Zip Phone 3.00
f /
L UY 721( 6Y-/-'m r} e or busi ) ( CHECK ALL 'Boiler Heat Air
THAT APPLY: or Pump Cond Qty Price Amt
N a
t /
C eO� 0_ 1 �'.K 6) <3HP;absorb unit to Comp
Occupant Mang Add 44' 100K BTU 6.00
I c 4 7 ( 5 - Y.-0 C� 2 7) 3-15 HP;absorb unit
City/State Zip Phone 100k to 500k BTU 11.00
- 11930 0 (6 i9 • , f _ • 9• 8) 15 -30 HP; absorb
- unit .5 -1 mil BTU 15.00
Contractor W am8 - 9) 30-50 HP; absorb
L xel, /m v i .- s �f A Q, /� unit 1 -1.75 mil BTU 22.50
Prior to permit Mailing Ad ress p t� 10) >50HP; absorb unit
issuance, a copy I ( 1 „� �F,�-( r(;`CIN >1.75 mil BTU 37.50
of all licenses s e zipc hb� Phon 11) Air handling unit to 10,000 CFM
are required if �'f � J - 4.50
expired in COT r �.Const nt. Bo # p• 12) Air handling unit 10,000 CFM+
database J / (.° f 7.50
Architect Name 13) Non - portable evaporate cooler
4.50
or
Mailing Address 14) Vent fan connected to a single duct
3.00
15) Ventilation system not included in
Engineer city/state Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done:
4.50
17) Domestic incinerators
New ® Repair 0 Replace with like kind: Yes 0 No 0 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 ISP LPG 0 electric 0 22) Otheiunits A ‘)1 S '- 41 i
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
Sign of Owner /Agent Date
Minimum Permit Fee $25.00 SUBTOTAL .1 �
V 9 5 % SURCHARGE ti
o ct Pe on Nam Pho a PLAN REVIEW 25% OF SUBTOTAL '
Required for ALL commercial permits onl -
Q/J(, Z TOTAL �����
"State Contractor Boiler Certification required
**Residential A/C requires site plan showing placement of unit
I:\rnechperm.doc rev 07/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
[� BUP
Date Requested �l --6 c1 AM PM BLD
Location /9 3 l / / C • Suite MEC q9 yd
Contact Person G e t c , j)" Ph 02 8o? PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: I
Foundation O A FPS
1
Ftg Drain �'"^�"�"
Crawl Drain Inspection Notes:
SGN
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
;PART FAIL
Post & Beam il)c,
Rough
Line In
Gas
Smoke e e
Dampers
AS PART FAIL
RI
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 • Q
Other Date `� Inspector ° E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.