Permit �
A CITY OF TIGARD
MECHANICAL PERMIT
u+' I 4 r DEVELOPMENT SERVICES PERMIT #: MEC1999 -00457
A '' 11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/26/1999
PARCEL: 1 S134CD -00500
SITE ADDRESS: 11895 SW KATHERINE ST
SUBDIVISION: LERON HEIGHTS NO.3 ZONING: R -4.5
BLOCK: LOT: 075 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:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Furnace and gas piping
Owner: FEES
DANIELS, RICHARD C Type By Date Amount Receipt
CAROL L PRMT BON 10/26/19c. $50.00 99- 319336
11895 SW KATHERINE ST 5PCT BON 10/26/19f $4.00 99- 319336
TIGARD, OR 97223
Total $54.00
Phone:
Contractor:
SOUTHWEST SHEET METAL
10415 SW 72ND
PORTLAND, OR 97223 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 246 -6284 Misc. Inspection
Reg #: LIC 00045089 Final Inspection
PLM 19WHI
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,- 10 through OAR 952 - 001 -0080.
You may obt.'- copies o ese rules or direct - to OUNC by allin 450 -9189.
Issue By: f , L 1,.._ Permittee Signature: . ,(.7\.. ..),...--------
• Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Chec
CITY OF TIGARD Mechanical Permit•Application Rec'd By ��
13125"SW HALL BLVD. Commercial and Residential Date Rec'd I V - 14 -g
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST A
Print or Type Permit# "t - "r! !
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
A) Permit Fee " .;; „ , u 16.00
Job Street Address \ �O suite# •
Address 1 �c S� �Gt�� I, ft"'ue. 1) Furnace to 100,000 BTU . including ducts & vents see footnote 1,2 f 9.65 ,"'6
Bld City /State Zip 2) Furnace 100,000 BTU+
including ducts & vents see footnote 1,2 12.00
Name (or name of business) � � �, � 3) Floor Furnace
Owner D - 1 L\3 �(� ,� C • including vent see footnote 1,2 9.65
Mailing Address / 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 9.65
\\S`1.5 14 6 b IrwA..t, 5) Vent not included in appliance permit 4.75
City /State x Zip Phone Check all that apply: *Boiler Heat Air
t U 9 72z j ✓ /�r / ' , Zz ( For items 6 -10, see or Pump Cond Qty Price Amt
am�(or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU 9.65
Occupant Mailing Address 7) 3 -15 HP; absorb unit
100k to 500k BTU '"" 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
9) 30 -50 HP; absorb
Contractor Name {- (/ ' /l ,4/ / unit 1 -1.75 mil BTU 36.00
sJ v\O4i•ea( U/IenrA/// ( 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy /Dc//,S , -t-) 7 Z 11 Air handling unit to 10,000 CFM
of all licenses City/State / �c. Zip Phone 7.00 .
are required if /j <raL U "17 2...S 2-4 6 12) Air handling unit 10,000 CFM+
• expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.85
database- F, 13) Non - portable evaporate cooler
Architect Name / • 7.00
14) Vent fan connected to a single duct
4.75
or Mailing Address
15) Ventilation system not included in •
• appliance permit 7.00
Engineer City /State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
• 12.00
New 0 RepaiFO Replace with like kind: Yes 0 No,0 /- 18) Commercial or industrial type incinerator
Residential7 Commercial 0 48.25
19) Repair units
Additional information or descriptio of work: in �` r 8.40
i 1 \ • ,� �SJ,,,v e rs r �U 20) Wood stove /gas FP /other units /clothe dryer /etc. 7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets 1 : Z
structural gas calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas E LPG 0 electric O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL ti. ,;! .00
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE _- z; ;.
�
given is correct, that I am the owner or authorized agent of PLAN REVIEW -25% OF SUBTOTAL A„,,, ' ' _ '
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only <Tn j ; ., A;
TOTAL y - 1.-1 OD
Signature of'Ownar /Agent Date t
i c >►\ I Other Inspections and Fees:
1. Inspections outside of normal business hours (mininum charge -two
Contact Pe „V n Name Phone hours) $50.00 per hour •
A481 �36 2,50D 2. Inspections for which no fee is specifically indicated (minimum
TI n '\ Q t i T 3 Itcp_ ,-(f 6 6 z � c) charge -half hour) $50.00 per hour
Foonotes for commercial projects only 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge- one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. *State Contractor Boiler Certification required
. * *Residential A/C requires site plan showing placement of unit
I:kmechperm.doc rev 7/19/99 . _
CITY OF TIGARD BUILDING INSPECTION DIVISION " MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/Z , BUP
D Date Requested (C ( AM PM % BLD
Location / l D 9 S r 2 , act✓ � _ n Suite MEC f g77
Contact Person�(/YK_ �L 4 /A) /L J. Ph PLM
Contractor Ph SWR
BUILDINGS :° " Tenant/Owner 66 -s 6 • 09c) -/ ELC
Retaining Wall ELR
Footing Access: •
Foundation / , C � / FPS
Ftg Drain /" �` �^' u-e SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
•
Firewall
Fire Sprinkler e (>
Fire Alarm 11�, —r
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
MECHANICAL
Post & Beam
Rough In
Gas Line
e Dampers 6 f T�7 totn it
Final
PASS PART FAIL
TRICAL
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 ( F0'1 1
1 Inspector l5' •'r'� Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.