Permit �. CITY OF T MECHANICAL
DEVELOPMENT PERMIT
4 11 SERVICES
ii 13125SWHallBlvd., Tigard, OR 639-4171
PERMIT # ° MEC98 -0196
DATE ISSUED: 06/02/98
PARCEL: 25110BB -01800
SITE ADDRESS...: 12395 SW CORYLUS CT
SUBDIVISION ° AMES ORCHARD ZONING: R -1 ,
BLOCK..... ..... ° LOT °007 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 ° 1 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP ° 0 REPAIR UNITS: '0
FIRE DAMPERS ?..: 30 -50 HP ° 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP ° 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Install new furnace & air conditioning. A/C units can not be placed
within the required setbact areas.
Owner: FEES
KAY MCGARRY type amount by date recpt
12395 SW CORYLUS CT PRMT $ . 29.00 GEO 06/02/98 98- 306210
TIGARD OR 97223 SPCT $ 1.45 GEO 06/02/98 98- 3062'10
Phone #:
Contractor:
ROBBEN & SONS HEATING
2300 SE 7TH AVE
P 0 BOX 14867 $ 30.45 TOTAL
PORTLAND OR 97214
Phone #: 233 -5841
Reg #. ° : 001884
REQUI RED 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 Heating Unt Insp
applicable laws. All work will be done in accordance with Cooling Unt Insp
approved plans. This permit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for more Final Inspection
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. .
A
a- IiIP'
Issue By: �� if---- ._Permittee Signature: ���� 4 ____
o f
+++++++++++- a++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
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Plan Check #
CITY OF TIGARD Mechanical Permit Application . .
. . Rec'd By • _
13125 SW HALL BLVD. ',.1 Commercial and Residential :k Date Rec'd
TIGARD, OR 97223 ; ' t: • ° • Date to P.E.
(503) 639 -4171, x304 �,
• :r, '.'.': : , : 1: 1:'�:r Date to DST .:%
.:%
Print or Type , Permit # lir „ (°.r(. cr"'C174;.
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description • . •
f)/0 �/LP Table 1A Mechanical Code QTY PRICE AMT
Job 55 trreetAddress 1 Q Q Suite# A) Permit Fee,., 1 . -0- -0- • 10.00
et
Address f r ,t:/.(i (:L. _
Bldg# /St ate • . , Zip • . 1.) Furnace to 100,000 BTU .! , 1 6.00
including ducts & vents
Name (or name of b i ss) 2.) Furnace 100,000 BTU+ • ' r . 7.50'
� f C including ducts & vents ' '
Owner � '
Mailing Address 3.) Floor Furnace f,,' , . ,,..1: , ,4 t, 6.00 "
" . including vent
•
City /State Zip I Phone 4.) Suspended heater, wall heater 6.00
or floor mounted heater •
Name (or name of business) 5.) . Vent not included in appliance permit , 3.00 •
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City /State Zip Phone 7.) Boiler or comp, heat pum , r co 11.00
3-15 HP; absorb unit to 50
Contractor N ♦ • 8.) Bo-3r H comp, heat pump, air cond. 15.00
'i� A , / 15 30 HP; absorb units -1 ;iii BTU"'
Prior to permit , air g A re trE pm, 0 O 9.) Boiler or comp, heat.pump, air Bond: 22.50 •
issuance, a copy J `k> 30-50 HP; absorb unit 1- 1.75mil BTU"'
, of all licenses i to P one ti!' �i
10.) Boiler or comp, heat pump, air cond. 37.50
are required if 902 "7 > 50 HP; absorb unit 1.75 mil BTU**
expired in COT Oregon Const. Cgn� pa i c.# Ex i p 11.) Air handling unit to 10,000 CFM 4.50 -
database o�
Architect Name . 13.) Non - portable evaporate cooler 4.50
:, or Mailing Address 14.) Vent fan connected to a single duct 3.00 •
, .
r •
. Engineer : City/State Zip Phone 15.) Ventilation system not included in 4.50
- - i . ' appliance permit '
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50 '
to be done Residential 0 Non - residential 0
, , Additional Description of work: 17.) Domestic incinerators 7.50 • ^.• {•:>' . • 18.) Commercial or industrial type ' 30.00
Incinerator
Existing use of , 19.), Repair units 4.50
•
' building or property
. 20.), Wood stove 4.50
1 it
•
Proposed use of , 21.) Clothes dryer, etc. 4.50
building or property •
22.) Other units 4.50
•
Type of fuel - oil 0 naturatgas 0 LPG 0 electric 0 • 23.) Gas piping one to four outlets / 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is corr that I am the owner or authorized agent of
the owner, that pla submi ed are in compliance with Oregon State ' QTY. SUBTOTAL ' - '
laws. .
Signature of er /Age hpr Date 'SUBTOTAL -
:, . P II / A
r 5 5% SURCHARGE -Ka
tact Pers • Name Phone PLAN REVIEW 25% OF SUBTOTAL --�
r
TOTAL
•
36-4.
i:\nechpmt.doc (rev 9 'Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit.
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 12 S CU' ) / ! Suite MEC en -br q�
Contact Person / t 1�1 Ph .2.3 ,-sgq I 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 / Q4S i i t. T 5 3 o
Insulation
Drywall Nailing /5 m, 4 S c7?)
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
EIII ECHA; C
Post & Beam
Rouah In ✓
Oas0.&-
Smoke Damp
4E SSA PART FAIL
CTRICAL
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
Othe r 5
Approach/Sidewalk Date . -� Inspector . Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.