Permit CITY OF TI GARD MECHANICAL PERMIT
IW1i DEVELOPMENT SERVICE -PERMIT #: MEC1999 -00519
j 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639a4911 DATE ISSUED: 11/29/99
/ .4 PARCEL: 1S135CC-02500
SITE ADDRESS: 10265 SW KATHERINE ST
SUBDIVISION: GREENBURG HEIGHTS ADDITION ZONING: R -4.5
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: OTR 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
FURN > =100K BTU: , <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of gas insert only, gas line already in place.
Owner: FEES
JEFF ZWINGRAF Type By Date Amount Receipt
10265 SW KATHERINE ST PRMT DEB 11/29/99 $50.00 99- 320042
TIGARD, OR 97223 5PCT DEB 11/29/99 $4.00 99- 320042
Total $54.00
Phone:
Contractor: •
TOM BISHOP CONSTRUCTION
11525 SW CANYON
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 503 - 626 -4652 Final Inspection
Reg #: LIC 00054696
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 m re"th - n480 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Uti'tSNotification C nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
Ydu may obtain copi- of the -e • =s or di ect questions to OUNC by callipg (503)246 -91:9
sue By: Iif /jL , Permittee Signature: fc •,
1 D'h
Call (503) •39 -4175 by 7:00 P.M. for inspections needed the next business day
CITY OF TIGARD Mechanical Permit Application R B,,,j `
13125 SW HALL BLVD. Commercial and Residential Date Redd /AM 1 , , :
TIGARD, OR 97223 Date to P,E. ,,
(503) 639 -4171, x304 Date to DSt .r__ .
Print or Type mt'tt .r •k" " .
' . �ilYlgfi , ✓xd ,. �'• t i�'l � 4
Incomplete or illegible applications will not be accepte
Name of Development/Project Description rr
Table 1A Mechanical Code " Price 'Anil ' 4.
Job Street Address ``'' Suite# A) Permit Fee 16.00 ' `'
Address /(2.6 .c; $Cc>t litir,n � J� 1 ) Furnace
duding to cis & vents
sag# city/state zip induding ducts 8 vents see footnote 1,2 � 9.65
2) Furnace 100,000 BTU+ r
induding ducts & vents see footnote 1,2 1200
Name (or name of business) 3) Floor Furnace
Owner z (.c i y(c Irl ��c` c �- induding vent see footnote 1,2 OA ". ,
g /) 1 4) Suspended heater, wall heater
Mailin
UU . or floor mounted heater see footnote 1,2 9:65 r 'y
/662&<, Sw ` t G"l r f 1 t ' S'( 5) Vent not included in a,pliance permit 4.75 t
City/State Zip ' Phone Check all that apply: *Boiler Heat Air
/l AAYC� aim �� 3 &To 1dl For items 6-10, see or Pump Cond fit, Price Mft
(or name a business) footnotes 1,2 Com
6) <3HP;absorb unit to
S A mC 100K BTU 9.85
Occupant Melling Address 7) 3-15 HP;absorb unit •+
100k to 500k BTU 17.66 S , k
CnylState Zip Phone 8) 15 -30 HP; absorb L •
unit .5-1 mil BTU " , ' 2418 : z , , -
9) 30.50 HP; absorb " -(r✓;t ' .'
Contractor Name p t( // unit 1 -1.75 mil BTU 9600
My)/ r3, S ite p Cn ti 51vuCfito4` 10) >50HP; absorb unit •-
prior to permit Maiting Address >1.75 mil BTU 80.16
Issuance, a copy /7,53 S SGk_) ( ?pU OK-- 11 Air handling unit to 10,000 CFM ® ` s.
of all licenses c� ''/state /� Zip Phone 7.00
are required if /JPCY.aJ 1 �0 �1 0{906 6 - y &s.L 12) Air handling unit 10,000 FM+
expired in COT Oregon contd. Cont. Board Llc.# Exp. DO ' 11.75
database S , /c, W., //-/L 13) Non - portable evaporate cooler . •
Architect Name . • 7,00
14) Vent fan connected to a single dud - g ° >4, r
' , ' , 415' z�
or Mailing Address o
15) Ventilation system not included in , ,
ay•!lance •= rmit °''� 7.00
Engineer City/State Zip Phone 16) Hood served by mechanical exhaust ' • 7
Describe work to be done: - Domestic incinerators • ;a "'�' _ ) �
R , ir O Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator
Commercial o
19) Repair units � i ,.- •
Additional inforl�tation or description of work: �Y s s`
20) Wood stove/gas FP/other - ..._
as ; n st,4- c o i ects on a 1, he nits over 400 lbs. 14 plch ;t""4 � ; , f
N&E: For Commercial projects 21) Gas piping one to • ou1Nb ^ ,,, . * , t .
require 21 �
structural gas talcs. See footnote 1 `''>` ` .." ' � + ,, liP
Type of fuel: oil 0 natural gap( LPG 0 electric 0 22 More than • =r outlet each ' r µ t'.k WI.,iv , ice a r '
Minimum Permit Fee $50.00 SUBTOT „ ...74M111 :
I hereby acknowledge that I have read this application, that the information 9% SUR i .., it ,,,,,, given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL r
the owner, that plans submitted are in compliance with Oregon State laws. R - • wired for ALL commercial • nits on ■ ' _,4r...
n ® tg pr
k . Signature t Date �:, ;
Y
,
;J 4t) if --, �j ! q / _ 1. Inspections OUtSid114,40 1111. 4 „ rf F� k ; R t
schematic of existing Phone hours) $50.00 per hour w =i;�
Y L 1L 2. Inspections forwhkh,otb "
t 4 � .L P u IA IA r VL f Z D� �` � � S charge -half irouh`S 60 � ,`
' R1MfN v -' " S ''y -7
�. 1. for ercial projects only:
1. P 3. Additional plan review req Provide full and proposed gas line and pressure. " t .
9 Pn� 9 P plans (minimum charge -on � � v ,�,,,�„ a��� '�`�?f
2. Provide drawings to scale showing existing and proposed mechanical ""'?"" v ,, ! - 4 � �.
units. 'State Contractor Boile Certification • a ., e' '°? t
**Residential A/C requires site plan ""'t' ' , "
'�.. ;' 1:lmechpenn.doc rev 02/4/99 y ~� •
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested � - ( AM 'PM BLD
Location /Dad Suite MEC (qt. ` dz ?
Contact Person R u` Y1•Y� ' 1404 S pot' fi &C ( (4(495;)-- PLM
Contractor / U / Ph SWR
BUILDING, ; :KS,n,`, :q,;- Tenant/Owner ELC
Retaining Wall ELR
Footing Acces
Foundation FPS
FPS
Ftg Drain j
Claw
Crawl Drain In Ion es: ! SGN
C�S C4xSL 1r'r" - 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
PASS FAIL
Pose Beam
Rough In
Gas Line
Smoke Dampers •
O P PART FAIL
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
Other
Date / Inspector 27 Ext
Final
. PASS PART FAIL DO NOT REMOVE this inspection record from the job site.