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Permit
A lt - OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC1999 - 00574 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/29/1999 PARCEL: 1S135AB-00100 SITE ADDRESS: 10255 SW 90TH AVE SUBDIVISION: TOWN OF METZGER ZONING: R - 4.5 BLOCK: LOT: 005 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: 1 EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: El VENTS W/O APPL: VENT SYSTEMS: STORIES: 1 BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: GAS 3 - 15 HP: COMML. INCIN: MAX INPUT: 72,900 BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES: GAS PRESSURE: M 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Remarks: Installation of gas pack furnance weighing less than 400 lb. A restricted energy permit is required. Owner: FEES WASHINGTON CLACKAMAS CO Type By Date Amount Receipt SCHOOL DIST 23J PRMT KJP 12/29/19. $50.00 99- 320755 13137 SW PACIFIC HIGHWAY PLCK KJP 12/29/19. $12.50 99- 320755 TIGARD, OR 97223 5PCT KJP 12/29/19. $4.00 99- 320755 Phone: Total $66.50 • Contractor: ARROW MECHANICAL 10330 SW TUALATIN RD TUALATIN, OR 97062 REQUIRED. INSPECTIONS • Gas Line Insp Phone: 692 -1565 Mechanical Insp Reg #: LIC 000051 Duct Inspection ELE 34 -47CLE 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 p of these rules or direct questions to OUNC by calling (503) -9189. Issue By: - Permittee Signature: X e Call (503) 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 l Date to P.E. (5 @3)'639 -4171, x304 / � r Date to DST 1 2 - y- / Type orT e �' D ermit# M6 /ffq-0 1 Incomplete or illegible applications will not be accepted Called N e o eve opment/Proi a ',�[� Tabl 1A Me chanical Code '� / / ` Description � Qty Price Amt J Job s�ty�e to /66-1" suit A) Permit Fee 10.00 IOC /, J I r Address �/ J w 1) Furnace to 100,000 BTU including ducts & vents l 6.00 (' Bldg# t /te Zip ? 2) Furnace 100,000 BTU+ J ZZ including ducts & vents 7.50 Name (or na/ bus ess) 3) Floor Furnace Owner / ` 46,0 // L P including vent 6.00 Ma iling AF(dress 4) Suspended heater, wall heater 3> - or floor mounted heater 6.00 ' P4e,',QC �� 5) Vent not included in appliance permit City /State Zip Phone /� 3.00 --� 6 , O 99-203145Y-e300 CHECK ALL *Boiler Heat Air Na (or ame of business THAT APPLY: or Pump Cond Qty Price Amt �� )� -�y/� Comp ** 6) K BTU unit to p Occupant Mailing ding A e s 100K BTU 1 6.00 b � ZSS S CU 9 ® 7) 3 -15 HP;absorb unit St A Zi I Phone 1005 to BTU 11.00 U 1 1 8) 15 -30 HP; absorb Contractor N ; ' Y(kJ unit .5 -1 mil BTU 15.00 / '/ I e 11 kill l l u) 30 HP; absorb Y{' t� unit 1 -11.. HP; 75 mil BTU 22.50 Prior to permit M ili dress !,, t 10) >50HP; absorb unit issuance, a copy io 5 , Vtf , ,(i.- iV . >1.75 mil BTU 37.50 of all required oitr/ � *, , ` i / t � 2 _ 1) Air handling unit to 10,000 CFM 4.50 are uired if Al (� ( rJl� � J /zS 1 expired in COT Oregon Const. o rd Lic.# Exp. Date /►f.J 12) Air handling unit 10,000 CFM+ database OS - 19 B oa 11—i3-.90 (((777 ►yV 7.50 Architect Name 13) Non - portable evaporate cooler /( 4.50 Or Mailing A dress 14) Vent fan connected to a single duct 3.00 15) Ventilation system not included in Engineer City/State Zip 1 Phone appliance permit 4.50 16) Hood served by mechanical exhaust Describe work to be done: 4.50 17) Domestic incinerators New 0 Repair 0 Replace with like kind: Yes 0 No 0 7.50 Residential 0 Commercial 18) Commercial or industrial type incinerator 30.00 Additional information or description of work: 19) Repair units - —IBS LL © /:2 47- 4.50 20) Wood stove C am__ P(�i�`'D - 4.50 ?�,� ( t i 21) Clothes dryer, etc. 4.50 Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) Other units 4.50 I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets 1 given is correct, that I am the owner or authoized agent of 1 2.00 the owner Ins submitted ar . . nce w�Or son S ate jaws. 24) More than 4 -per outlet (each) Signs u Owner /Agen D to Minimum Permit Fee $25.00 SUBTOTAL ged av-4.5s 0:: 0 ..- Q ,�(a SURCHARGE —1 Con erson Nam Phone PLAN REVIEW 25% OF SUBTOTAL J Required for ALL commercial permits only � :. ' i7 TOTAL 1 T � *State Contractor Boiler Certification required * *Residential NC requires site plan showing placement of unit I:\rnechperm.doc rev 07/20/98 OVER- THE - COUNTER (OTC) PERMIT COMMERCIAL MECHANICAL PERMIT CHECK LIST Description of Project: _PA J-) - /�-L r 4-? L0 D / /4-f - r/u k' P —'i r-rt et r 4 tA. e-.)) )' 1 r ;� Leff l 6 �, Y d t Q v /R fl 1?- ,7, -'r,' Class of Work: 4- t Floor Furnace: ( Evap Coolers: Type of Use: l'Cm Unit Heaters: Vent Fans: Occupancy Grp: /_ -. I Vents w/o Appl: Vent Systems: Stories: / Boilers /Comprsrs: Hoods: Fuel Types - 0 - 3 HP. / Repair Units: Chi / / / / 3 - 15 HP. Wood Stoves: Max Input: 72 goo Btu: Air Handling Units Clo Dryer: Fire Dampers: , <_ 10000 cfm: - Oth Units: Gas Pressure: H / L > 10000 cfm: Gas Outlets: / No. Of Units: Furn < 100k Btu: Furn >_ 100k Btu: NOTES: ' COMMERCIAL INSPECTION ACTIONS : - xf ` F MENU '4 • Gas Line Inspection $ O Permit Fee $ p ✓ Plan Review Mechanical Inspection � Cooling Unit Inspection $ t. e..—V■13% State Surcharge Shaft Inspection $ Additional Permit Fee Hood Inspection $ Additional Plan Review Fee Fire Suppr Inspection $ Inspection Fee Duct Inspection $ Miscellaneous Fee ,,, Fire Alarm Inspection 6 b Fire Damper Inspection REMARKS: Miscellaneous Inspection - Fire Alarm Inspection yi Final Inspection 4 IFOW OFFICE USD 7 i QNL�Y s -�� �a,�..r. � �,',`.'xe - �� -. �'�r . e ms ': a TYPE OFUSE OPTIONS (COM - co m ercia ; GMS . commercial onufackur ct vre} s - I ACS = a ccesso r , ° , ", �-Gl 11 VORK flF?TtC11VS'>F.OR• LL, (N, neinw AD � _.adddron, ALT = atterabott;_ =; �,.�, ; .,_ rY.<::__,"v,��, <iFND°= fou oop; 0- " other; DEMO ° demolition; REPT,M r = �fii'e p ion-:s t em NO E = USE 9TH- FORTENp S RETAINING .a LL, ©ETACHEDDDECKS ,. i- : ;. <� ,i'' 1?1i'A • � SIGhISAWTiINGS,CANOPIES) `? mss: _ -. ; ; � �, . re. I: /dstlforms /otemech.doc 9/99 i:\dsts\forms\otc-mech.doc9/99 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business 'Line: 639 -4171 r/ BUP Date Requested / �S AM PM BLD Location 1 0 2 ,S q • Suite 1 qq q – OE 57 1 � Q Y1U& Ph (0q2 Contact Person • � ' e -�.�,. �--�'_ Contractor P_ h SWR - Tenant/Owner / 1 V: -i - - e� % ► ) "t%1 ELC Retaining Wall ''� ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain InSpectloll t G SGN Slab M CAT Y ;,.;t .Y -, , :: en -c SIT Post & Beam Ext Sheath/Shear C>t'e [ (1C. 4 t S I4 0 01. k H 04 - Int Sheath /Shear Framing Insulation Drywall Nailing Firewall — Fire Sprinkler � A 145; v e //� Fire Alarm 1' 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 I4 .`HAN(C) Post & Beam Rough In Gas Line •1. Smoke Dampers 41% PART FAIL E CTRICAL Service Rough In r 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 /) /) Other Date /// � (�(/ Inspector '� Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.