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Permit CITY OF TIGARD MECHANICAL %n DEVELOPMENT SERVICES PERMIT PERMIT : MEC98 -0368 13125 SW Hall Blvd., Tigard, DATE ISSUED: 08/25/98 PARCEL: 25110AB —HMOO7 SITE ADDRESS...: 11455 SW JACKIE CT SUBDIVISION ° HAWK MEADOWS ZONING: R -4.5 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. T.NCIN: 0 :GAS 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..: 0 GAS PRESSURE...: 50+ HP....: 0 CLO DRYERS..: 0 NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0 FURN < 100K BTU: 0 t= 1 0000 cfm: 0 GAS OUTLETS.: 1 FURN > =1O0K BTU: 0 > 10000 cfm: 0 Remarks: Owner: FEES RIVERWOOD DEVELOPMENT LLC type amount by date rerpt 4035 DOUGLAS WAY PRMT $ 25.00 JSD 08/25/98 98- 308584 LAKE OSWEGO OR 97035 SPCT $ 1.25 JSD 08/25/98 98- 308584. Phone #: Contractor: SPECIALTY HEATING & FABRICATTO 9528 SW TIGARD ST -- $ 26.25 TOTAL TIGARD OR 97223 Phone t: 620 -564 Reg St..: 006657 REQUI RED INSPECTIONS This permit is issued subject to the regulations contained in the Gas Line Ins p 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 gay obtain copies of these rules or direct questions to OUNC by calling (503)246 -9187. Issue By: ` Permittee Signature:j.,(,1i4� ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call .639 -4175 by 7:00 p.m. for inspections needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Plan Check # CITY OF TIGARD Mechanical Permit Application Rec'd B 13125 SW HALL BLVD. Commercial and Residential Date Rec'd °,K� S' % a TIGARD, OR 97223 Date to P.E. (503) 639 -4171, x304 Forvtn.et a o( d✓e5 :� : / 4135 S i l ti! it-k, - Date to DST Print or Type �/ Permit # 41 c-c'Q_ r i . 36 / Incomplete or illegible applications will not be accepted Call (P ' Na a of Development/Project Description G ()K �714v 7 7 Table 1A Mechanical Code Qty Price Amt .lob � A) Permit Fee reef Address Suite# ) 10.00 Address (1 SO d ,Le. &-. 1) Furnace to 100,000 BTU including ducts & vents 6.00 • . Bldg# . City /State Zip 2) Furnace 100,000 BTU+ 1 l ed- Ole 9 7;422.3 including ducts & vents 7.50 • Nam (or name of business) 3) Floor Furnace Owner (�U'GG �GCCJ . 41,6„, including vent 6.00 Mailing Address 4) Suspended heater, wall heater `10 35 �(J n� ) oor mounted 6.00 � W 4 Vent Vennt not included in appliance in appliance permit � �'�� Cit /State Zip Phone 3.00 Adj L/, Odiv ao 4 ?70 6 35 _ 21..o CHECK ALL *Boiler Heat Air Name (or name of busine s) THAT APPLY: or Pump Cond Qty Price Amt Comp ** 6) <3HP;absorb unit to • Occupant Mailing Address 100K BTU 6.60 7) 3 -15 HP;absorb unit i City/State Zip Phone 100k to 500k BTU 11.00. 8) 15 -30 HP; absorb • unit .5 -1-mil BTU 15.00 'Contractor Name 1 9) 30-50 HP; absorb 5p i to -6,4 1L-1 f ±.1.1 2� unit 1 -1.75 mil BTU 22.50 _ Prior to permit Mailing Address / 10) >5OHP; absorb unit ,t5 issuance, a copy C ' Sly I l C Q y d a >1.75 mil BTU 37.50 • . • - of all licenses :City /State ,/ n J Zip Phone 11) Air handling unit to 10,000 CFM are required if 1 L ldi td De. or l -.56 3 4.50 expired in(COT ore Const. Cont. Board Lic.# Exp. Date . 12) Air handling unit 10,000 CFM+ - database 1p4,, 1 7 3 �J /l i l 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 ~ 4.50 Describe work to be done: ck aticie. L Is o r gas LliLe 17) Domestic incinerators • New 0 Repair Replace with like kind: Yes /No 0 7.50 Residential 6 Commercial 0 LL� , 18) Commercial or industrial type incinerator , E.t. me / �t�Y . 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 /LPG 0 electric O 22) Other units 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 ( Signature of Owner /Agent Date ,p Minimum Permit Fee $25.00 SUBTOTA '� // 5k 11 ril.cL±h, L 3 5 %SURCHA "� f Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL , f x.,�r l Q�C ` O Required for ALL commercial permits only , A ( . 1 p�/ ( c TOTAL `t� to.,tf 1 *State 'Contractor Boiler Certification required * *Residential A/C requires site plan showing placement of unit I:\mechperm.doc rev 07/20/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 n BUP 3 Date Request d AM PM BLD Location 11455 CI GVt Suite MEC W 0.3&? Contact Person f r �� , V � � _ Ph PLM Contractor I Ph 6e? SWR BUILDING �° ; ` Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation /f /�' FPS Ftg Drain � ` _f� Crawl Drain Inspection Notes: SGN Slab /�� /� �J� Post & Beam Ext Sheath /Shear �� (,Q.(� . Simi, iv "Ardt Asue SIT Int Sheath /Shear Framing Tom /y ©O Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: • Final PASS PART FAIL PLUMBING` Post & Beam Under Slab Top Out n Water Service J� �/ Sanitary Sewer C /y Final Drains a Final __E _ PA RT FAIL J V Post & Beam Rough In r Gas Line," Smoke Dampers anal S PART FAIL ELECTRICAL _ Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS 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 Approach /Sidewalk - / Q� / , Other Date / / Inspector ( /Gt Ext Final PASS PART FAIL DO NOT RESIiI,OVE this inspection record from the job site.