Permit .•i CITY OF T MECHAN I CAL
A Np DEVELOPMENT SERVICES PERMIT
� I'�
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT #.......: MEC99 -0027
DATE ISSUED: 01/15/99•
PARCEL: 251 15BC- 16_00
SITE ADDRESS...: 12365 SW KING RICHARD DR
S1JBDIVISION... < : ZONING:
BLOCK........... LOT.............: JURISDICTION: KIN
CLASS OF WORK..:ALT FLOOR FURN....: 0 EVAP COOLERS: 0
TYPE OF USE.....:SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES........: 0. BOILERS /COMPRESSORS HOODS.......:
FUEL TYPES -- 0 -3 HP....: 0 DOMES. I NC I N: 0
3 - 15 HP....: 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 - 30 HP....: 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP....: 0 WOODSTOVES..: 0
GAS PRESSURE....: 50+ HP....: i2' CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0' GAS OUTLETS.: 0
FURN ) =100K BTU: 0 > 10000 cfm: 0
Remarks Replace furnace.
Owner: ----- - - - -•- -
PAUL ELLIS type amount by date recpt
12365 SW KING RICHARD DR PRPIT $ 25.00 DLI--1 01/15/99 KING CITY
KING CITY OR 97224 5PCT $ 1.25 DLH 01/15/99 KING CITY
Phone ##: 59t3 --1137
Contractor: -
HEATING SPECIALIST INC, THE
9300 NE HALSEY - - - - - -- --
• $ 26.25 TOTAL
PORTLAND OR 97220
Phone #: 257 -7000
Reg # #..: 000566
- -- REQUIRED INSPECTIONS --
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection ,•
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 -001 -0010 through OAR 952 -001 -0080, You may
. obtain copies of these rules or direct questions to OUNC by calling •,-__ _ -,_--
(503)246 -9187.
Issue By I Y Permittee Si. gnat ure:/O%GE6 OT/C94 C'1/�
+++++++++++++- i-++++++++++++++++++++++++++ + + + + + + + + ++ + + + + ++ + + + + + + ++ + + + + + ++ 4• ++ + + + ++
Call 639 by 7:00 p.m. for inspections needed the next business day
++ d-++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + ++ + + + + + + + + + + + + + + + + + ++ + + +'
•JAN- 15 -'99 FRI 09:58 ID: FAX NO: 4059 P02
• ) � f RECEIVED JAN 1 4 1999
0
- CITY OF TIGARD r, ' =r.7 Permit Application Rec lication ecdByek/e
' By Rii
13125 SW HALL BLVD. Commercial and Residential Date Recd /- `l
TIGARD, OR 97223 JAN 1 1 1999 Data to P,E, p
4;4r - Date to DST / -/ le (503) 639-4171, xeJ t 4 tu,�lt „ EveLoPM Eryt� �
Print or Type Permit #/�1�FL'Q?'L� 7 „ -,
Incomplete or illegible applications will not be accepted Called
Nome or DevelopmeevproJee Description
Table 1A Mechanical Code Q Price Amt
Job Street Address Sufe# A) Permit Fee 10.00 .
Address rZ3Co5 Sc..) Ktng �c�hau -d. 'Or 1) Furnace to 100,000 BTU
including ducts & vents 6.00 60:'
atdget City/State tip 2) Furnace 100,000 BTU+
includlng,ducts & vents 7.50
Name (or name of business) 3) Floor Furnace
Owner rc a..L i. E., t l i5 including vent . 6.00
mailing Address 4) Suspended heater, wall heater
or floor mounted heater 6.00
f 2 3 ( o S J l` tr�� tG `tcy �r 5) Vent not included in appliance permit •
CAy /State Zip Phone ■ 3.00
k t r151 C q ' 4 -t 9 B - 1 l3 7 CHECK ALL • "Boller Heat Air
Name (dleme or cosiness) THAT APPLY; • or Pump Cond Qty Price Amt
Comp
6) ' 3HP;absorb unit to
Occupant Melling Address 100K BTU :. 6.00
7) 3 -15 HP;absorb unit
city/state Zip Phone 100k to 500k BTU 11.00
8) 15 -30 HP; absorb '
_ unit .5 mII BTU 15 -00
Contractor Name 30 -50 HP; absorb
_` k . . I Tmr 9 Spo _ LI s T unit 1 -1.75 mil BTU , 22.50
Prior to permit Malting Adams - 10) >50HP; absorb unit
issuance, a copy q 3 ro 2, 1itaL54E >1.75 mil BTU 37.50
of all licenses , 8�t ZIP Pnono 11) Air handling unit to 10,000 CFM
are required if tK'ao �AtJ ® � 41.13.-21, Z57-"l 0 , a 4.50
expired in COT otegon Coast. Cont. Board Ucl. Exp. beta 12) Air handling unit 10,000 CFM+•
estabase a Co to 1$ .5-1 a_ `1`i' 7.50
N ame 1 3) Non- portable evaporate cooler 4
Architect • 4.50
or Mailing ^ddreee 14) Vent fan Connected to a single duct 3.00
15). Ventilation system not Included in
Engineer City/State Zip ' Phone appliance permit . 4.50
16) Hood served by mechanical exhaust
Describe work to be done: ' • •
• . , 4.50
17) Domestic incinerators •
New 0 Repair 0 Replace with like kind: Yes Ili No 0 „ 7,50
Residential 0 Commercial O 18) Commercial or industrial type incinerator
30.00
Additional Information or description of work: . 19) Repair units
a .50
f sa.4_au -r—. a,_4 20) wood stove
�a 7 4.50
•
21) Clothes dryer, etc. • •
4.50
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) Other units .
4.50
I hereby acknowledge that I have read this application, that the information 1 23) Gas piping one to four outlets •
given Is correct, that I am the owner or authorized agent of • 2.00 ,
the owner, that plans submitted are in compliance with Oregon State laws. . 24). Moro than 4-per outlet (each) •
.50
Signature of Owner/Agent Date Minimum Permit Fee 525.00 • • SUBTOTAL ''• .ZS —
• �7t' I /2,99 5% SURCHARGE II-5
Contact Person Name Phone • . PLAN REVIEW 25% OF SUBTOTAL ` - • •
- Required for ALL commercial permits only ' w • . : 0 • '
— ame� ? 7 000 TOTAL �.+ .. M........,.., ( o S
"State Contractor Boiler Certification required -
* *Residential A/C requires site plan showing placement of unit .
l:lmechperm -doe rev 07/20/98 •
Te'd C 01H H,I, LB':60 6661 -ST -NHf
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour inspection Line: 639 -4175 Business Line: 639 -4171
q BUP
Date Requested 3 - 2)7"%q I AM PM BLD
Location K, (Il J Okkia4A, Suite MEC 9 - ®o2 7
Contact Person G /1 Sp e, & Ph _.57-7(1t1D PLM
Contractor Ph SWR
B'UILDiNG . Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear e t'
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBINGG
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PAID FAIL
Post & Beam (,
Cough
In ~ j
Gas Line
Smokr Dampers
PASS PART FAIL
ELECTRICAL4N4 x`.
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS 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 Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Otheoach /Sidewalk Date 2,Z Inspector Oaniia/\
Final
PASS PART FAIL DO NOT RE OVE this inspection record from the. job site.