Permit Lit CITY OF TIGARD MECHANICAL PERMIT
:111 D EVELOPMENT SERVICES C DATE R MII #: M -00248
,. x
W 13125 SW Hall Blvd., Tigard, OR 97223 (503) 63 -
Y,
/ PARCEL: 2S114BB -14400
SITE ADDRESS: 10476 SW KENT ST
SUBDIVISION: SWANSONS GLEN NO.2 ZONING: R -12
BLOCK: LOT: 085 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: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Add Air conditioning to an existing dwelling. A/C units cannot be placed within the required setback areas.
Owner: FEES
KEN THORNBURG Type By Date Amount Receipt
10476 SW KENT ST PRMT DEB 6/11/99 $50.00 99- 316077
TIGARD, OR 97224 5PCT DEB 6/11/99 $2.50 99- 316077
Total $52.50
Phone:
Contractor:
SPECIALTY HEATING + FABRICATIO
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: 620 -5643 Final Inspection
Reg #: SUP 2570RET
LIC 006657
ELE 34-341CR
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 Notifi 'on Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You m obtain copies of - th -se rules or questions to OUNC by calling (503)246 -9189. -
Issue / _ � / / Permittee Signature: / .
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
CI OF TIGARD Mechanical Permit Application
13125 SW HALL BLVD. Commercial and Residential /N /q99 -*
` TIGARD, OR 97223 •
(503) 639 -4171, x304 .1r(
Print o Type
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address. 42uite# A) Permit Fee ? 16.00
Address r'O L` 9 (p 3 o.) "e0-141. 1) Furnace to 100,000 BTU
. including ducts & vents see footnote 1,2 9.65
Bldg# City/State Zip 2) Furnace 100,000 BTU+
f lga/ ) fig° 72, including ducts & vents see footnote 1,2 12.00
Na a (or p name of business)/ 3) Floor Furnace
Owner /1 . L' ` i-AgGi 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
/64 SG✓ 1 14 5) Vent not included in appliance permit 4.75
ay /st to Zip P hone Check all that apply: *Boiler Heat Air
C4 0e ?1d d - 57 5 For items 6 -10, see or Pump Cond Qty Price Amt
Narr (or name of business) footnotes 1,2 - Comp "" •
6) <3HP;absorb unit to
n 100K BTU 1 9.65
Occupant Mailress 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
Contractor Name
9) 30 -50 HP; absorb
unit 1 -1.75 mil BTU 36.00 .
A /G --/lid v (J // C-- 10) >50HP; absorb unit
Prior to permit Mailing Addre >1.75 mil BTU 60.15
issuance, a copy ?S SC / gal d2 5 ( 11 Air handling unit to 10,000 CFM
of all licenses City/State n Phone 7.00
are required if � Q/j de 77,7 4,43 6 12) Air handling unit 10,000 CFM+
expired in COT Orego6 Const. Cont. Board Lic.# Exp/Date/ 11.75
database 10657 S /// ( 1 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct
or Mailing Address 4.75
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 Repair 0 Replace with like kind: Yes 0 No 0 18)_Commercial or industrial type incinerator
Residential Commercial 0 48.25
19) Repair units
Additional information or description of work: 8.40
Q
•
20) Wood stove /gas FP /other units /clothe dryer /etc.
• / ri (c ,4' e- 7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electri 22) More than 4 -per outlet (eac .75
Minimum Permit Fee $50.00 SUBTOTAL jj,
I hereby acknowledge that I have read this application, that the information 5% SURCHARGE R 3-0 rr rrt f 7 r . i «.. fir .; ;.
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 :p:;
Signature of Owner /Agent Date ` 5
Other Inspections and Fees:
1. Inspections outside of normal business hours (mininum charge -two
Con ct Person Name - Phone hours) $50.00 per hour
2. Inspections forwhich no fee is specifically indicated (minimum
�.CiPY// . 4 * p charge -half hour) $50.00 per hour
F onotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing aril 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:\mechperm.doc rev 02/4/99
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
BUP
Date Requested AM PM BLD
Location / 0 Li Co „ Suite MEC /
Contact Person Ph PLM
Contractor Ph 67 ,17(5 SWR
Tenant/ar r _dm ELC l tt4):5 S
Retaining Wall I ELR
Footing
Foundation Access: cop 7)1
FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
ili.4.4
Slab SIT
Post & Beam
Ext Sheath/Shear
Int Sheath/Shear -
Framing
Insulation
Drywall Nailing v7hs/
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: iqqq e70-(,4?
Final
PASS PART FAIL /9 9 — 0 J )
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANIC
Post & Beam
Rough In
)'( j.
Gas Line
Smoke Dampers
r AS PART FAIL • ,
CTRICAL
#'()
Service
Rough In D(
UG/Slab
I '
Low Voltage
Fire Alarm
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 Su l Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ppy
ADA
Approach/Sidewalk
Other Date 6 Inspector Ext -
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site