Permit CITY TIGARD MECHANICAL PERMIT
j � DEVELOPMENT SERVICES PERMIT #: MEC1999 -00534
�^' ' 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/06/1999
PARCEL: 25111 BA -02800
SITE ADDRESS: 09815 SW JANZEN CT
SUBDIVISION: MCDONALD ACRES ZONING: R -4.5
BLOCK: LOT: 003 JURISDICTION: TIG
CLASS OF WORK: ALT 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 2
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installing gas woodstove, gas logs, and gas piping
Owner: FEES
DOUG LARSON Type By Date Amount Receipt
9815 SW JANZEN CT PRMT BON 12/06/19c $50.00 99- 320183
TIGARD, OR 97224 5PCT BON 12/06/19, $4.00 99- 320183
• Total $54.00
Phone: 503 - 620 -1753
Contractor:
PACIFIC GAS WORKS
PO BOX 30646
PORTLAND, OR 97294 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 317 -5573 Misc. Inspection
Reg #: LIC 136391 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 obt in copies of these rules or direct questions to OUNC by calling (503)246 -9189.
_ 1'�
Issue By: . L1LjlAgiG�L, Permittee Signature: /14.v4 :7
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
`' CITY OF TIGARD Mechanical Permit Application Rec'd Byck
13125 SW HALL BLVD. Commercial and Residential Date Rec'd l Z,"' 1,1
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit# M- C1,1,
Incomplete or illegible applications will not be accepted Called
Name of Development/ roject Description .
(I/\(' IA -t!ve5 Table 1A Mechanical Code Qty Price Amt
t Z - % ,
S treet ddress SuR A) Permit Fee e# �,, 16.00
Job r / 1) Furnace to 100,000 BTh
Address I g{/VV� including ducts & vents 9.65 .
Bldg# City/State zip 2) Furnace 100,000 BTU+
[ /�� / s/ ) including ducts & vents 12.00
•
Name (or name of business) ( ,i " 3) Floor Furnace
•
Owner Dpcl,i.c 4_ 9 I e2�1 , /p I including vent 9.65
Mailing dress 4) Suspended heater, wall heater
/i /5 s ( i V , A - or floor mounted heater 9.65
��j' �/� 5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
' T?4a 0r� 9722y � 20 : -/75 - 3 For items 6 -10, see or Pump Cond Qty Price Amt
N a e'(or name of business) f ootnotes 1,2 Comp •
6) Repair units
01 (, 8.40
Occupant Mailing Address 7) <3HP;absorb unit to
100K BTU 9.65
City /State Zip Phone 8) 3 -15 HP;absorb unit
• 100k to 500k BTU 17.65
Contractor Name 9) 15-30 HP; absorb
. ,- `_,S, 10) .5 -1 mil BTU 24.15
Pac, /J t � lOV y t/[ 10) 30 50 HP; absorb
•
Prior to permit Mailin Address unit 1 -1.75 mil BTU 36.00
issuance, a copy PD VOX 306 c 11) >50HP; absorb unit >1.75 mil BTU
of all licenses City/State Zip Phone 60.15
are required if )PT,tki / £9r - 97 • 3/ 7-5-5-73 • 12) Air handling unit to 10,000 CFM
expired in COT Oregon_Const. Cont. Board Lic.# c Ex . Date 7.00
database 1 363 5 / U'/k 13) Air handling unit 10,000 CFM+
Architect Name • 11.85
14) Non - portable evaporate cooler
Or Mailing Address 7.00
15) Vent fan connected to a single duct
. • 4.75
Engineer c ite -� Zip Phone 16) Ventilation system not included in
..--" • appliance permit 7.00
Describe work to be done: 17) Hood served by mechanical exhaust
7.00
New 0 Re air O. Replace with like kind: Yes O. jto 0 18) Domestic incinerators
Residential Commercial 0 Modification 12
19) Commercial or industrial type incinerator
Additional information or description of work: 48.25
-
20) Other u__nit�s including woo stoves ,,1
I 4 4 1 __5 + t ` i , 5e 3-- 7.00
NOTE: For Commercial projects only; Units over 400 lbs., located on the 2 1 Gas piping one to four outlet
roof, require structural calcs. prepared by licensed engineer. 1. 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) More than 4 -per outlet (each) . .75
acknowledge that I have read this application, that the information Minimum Permit Fee $50.00 SUBTOTAL t e ;, `�, GL
I hereby 9 PP 8% SURCHARGE ' L•0
given is correct, that I am the owner or authorized agent of o \,
PLAN REVIEW 25 /o OF SUBTOTAL
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only : } P a ,\
Signature of Owner /Agent . _ Date TOTAL 'Ne-17,'" P k f,}}
/0 /T 7 . Other Inspections and Fees:
Cont erso Name Phone
1. Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
h>
, Q -/75-3 2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
Foonotes for commercial projects only: Additional o plan review required 3.
1. Provide full schematic of existing and proposed gas ro , osed line and 0.r h ounges, additions or revisions to plans (minimum
pressure. charge hour) $550.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
• units. * *Residential A/C requires site plan showing placement of unit
1 :lmechperm.doc rev 11/1/99 .
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested f' i /s4 /q 9 AM • PM BLD
Q
Location -[ 1 i 5 .J Ck Suite MEC I 'q 1-- (posy/
Contact Person % j Ph (p 2'/ I S mac^ ? j PLM T Z9
Contractor /� Ph Co 31 SWR
BUILDIN;G`yPo" °° ,. Tenant/Owner /1 //�-,' g CA ELC
Retaining Wall ELR
Footing Access:
Foundation PIM 11'02M Z O(4 P p FPS
Ftg Drain r SGN
Crawl Drain Inspection Notes: e �? � C i _ c 2 o o �� �� SIT
Slab �X �/
Post & Beam I ry'� L e
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
S PART FAIL
III$ CHANTCA1g
Post & Beam
Rough In <
Smoke Dampers
Final
PART FAIL
ELECTRICAL
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
Date l
Other Inspector 7 23 / -- f Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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