Permit - CITY OF TIGARD MECHANICAL PERMIT
dal DEVELOPMENT SERVICES PERMIT #: MEC2000 -00300
,4- RBI I 13125 SW Ha Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/26/00
S^ W
PARCEL: 2 S 102 6 B -00410
SITE ADDRESS: 12050 SW KAROL CT
SUBDIVISION: KAROL COURT ZONING: R -4.5
BLOCK: LOT: 009 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: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
<= 10000 cfm: OTHER UNITS:
FURN > =100K BTU: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Replacement of gas furnace with like kind, installation of new a/c unit and gas piping. Placement of a/c unit
must comply with standard setbacks.
Owner: FEES
KRAUSHAAR, STEPHANIE E + Type By Date Amount Receipt
BEDNAREK, CHRISTOPHER F JR PRMT DEB 7/26/00 $50.00 0003998
12050 SW KAROL CT 5PCT DEB 7/26/00 $4.00 0003998
TIGARD, OR 97223
Total $54.00
Phone:
Contractor:
•
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 234 -7331 Heating Unt Insp
Reg #: LIC 1441 Cooling Unt Insp
Final Inspection .
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 -00 -0 Hugh OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calling 03)246 -91�g, ,
Issue 0 / i• id / �,, Permittee Signature:
Call (503) 639 175 by 7:00 P.M. for inspections needed the next business day
Plan Ch
CITY OF TIGARD Mechanical Permit Application Rec'd :. .W
1x3125 SW HALL BLVD. • Commercial and Residential Date Rec'd '7 00
TIGARD, OR 97223 Date to P.E. , - _ -
( 5 0 3 ) 639 -4171, x304 Date to DST ------
_ .. - _ .. - . - - Print or Type Permit # Mee2rx>- )
. Incomplete or illegible applic will not be accepted Called
Name of Development/Project Description . ' ') ''''' " ',-,•*:., -t-
•
e�ris �
\ N 4 r �(C - Table 1A Mechanical Code -4 R ~� Qty Price Amt
Job S treet Address Suite#
A) Permit Fee ' ; . 16.00
1� 1) Furnace to 100,000 BTU
Address ) ; S to kc,rO\ Ct including ducts & vents see footnote 1,2 / 9.65 %•(pS
Bldg# City/State Zip 2) Furnace 100,000 BTU+
■SQ rCi C3,- 9 7 D-9? including ducts & vents see footnote 1,2 12.00
Name (or name of business) `J 3) Floor Furnace
Owner CIA w , S g ed NCk rP IC 30 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
1,0 50 SL&3 �qv-( t C_}' - 5) Vent not included in appliance permit 4.75
City /State Zip I Phone Check all that apply: I *Boiler I Heat Air
1 x cA O e c � a a3 i - r�, -7 $ei For items 6 -10, see or Pump Cond Qty Price Amt
Na (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU / 9.65 T (oS
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
Name 9) 30 -50 HP; absorb
Contractor � unit 1 -1.75 mil BTU 36.00
, :in 0 --C HFCti-A yvC J S f\ I 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60:15
issuance, a copy 4 1 Li '..,F (r), . l io(Ll t C t P A 11 Air handling unit to 10,000 CFM
--
of all licenses , ( �� ity /State Zip Phone 7.00
.. are required if U-or'` De_ Rpaoa 93/-1 - X33 ) 12) Air :handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# • Exp. Date - ' .. 11175
database I L( Lt 1 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 Re air 0 Replace with like kind: Yeslo O 18) Commercial or industrial type incinerator
Residential Commercial 0 48.25
19) Repair units •
Additional information or description of work: 8.40
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
structural gas talcs. See footnote 1 / 3.75 3. 75
T of fuel: oil O natural gas X LPG 0 electric O 22) More than 4 -per outlet (each) .75
/ ` Minimum Permit Fee $50.00 SUBTOTAL „.., ` , , t OC
I hereby acknowledge that I have read this application, that the information ri i /o SURCHARGE " c?CJ
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL :_' '
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
TOTAL ``
Signature of Owner /Agent Date ;,
Other Inspections and Fees:
,0'1 's 1 hG.- '� I �' 1. Inspections outside of normal business hours (mininum charge -two
Contact Person Nam Phone hours) $50.00 per hour
S 1 2. Inspections for which no fee is specifically indicated (minimum
3 k , I V 61C uo 3'-1 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
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FAx .563- 234- 6.052_
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Reque ted ( AM PM B
Location /?-o SU 5r, ✓ ' - �' d • Suite c r 00Z00
Contact Person K0u\-6--Q Ph 351 3 LMi) Q - 0 do/ 7
Contractor • Ph SWR
BUILDING':: Tenant/Owner 4:19 „ ' 0 p - G U 42 7
Retaining Wall ELR
Footing : — // /
Foundation Accessb �• FPS
Ftg Drain C.• / /�/ V SGN
Crawl Drain Inspection Not S: •
Slab 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
UMB!N
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
ediffP Drains
Q` • RT FAIL
ANIC
Post & Beam
Rough In
Gas Line
Sm � - Dampers
1 . � , ,•
.7.„,;„: FAIL
ECTRI A •
Rough In
UG /Slab
Low Voltage
F - Alarm
MP PART FAIL
S
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 n `1 �^
Other Date jfh' I/ 0 0 Inspector 7 1i 0 ) Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.