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Permit CITY TIGARD MECHANICAL PERMIT V - PERMIT #: MEC1999 -00548 . �I�, DEVELOPMENT SERVICES DATE ISSUED: 12/09/1999 ---' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S111 CB -04200 SITE ADDRESS: 10491 SW LADY MARION DR SUBDIVISION: MARION ESTATES ZONING: R -3.5 BLOCK: LOT: 015 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: 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: 1 > 10000 cfm: GAS OUTLETS: 1 Remarks: Install gas piping to log set in single family dwelling. Owner: FEES CAMPBELL, DONALD G + PATTI B Type By Date Amount Receipt 10491 SW LADY MARION DR PRMT KJP 12/09/19c. $50.00 99- 320311 TIGARD, OR 97224 5PCT KJP 12/09/19c $4.00 99- 320311 Total $54.00 Phone: Contractor: PACIFIC GAS WORKS PO BOX 30646 PORTLAND, OR 97294 REQUIRED INSPECTIONS Gas Line lnsp Phone: 503 - 317 -5573 Misc. Inspection Reg #: LIC 136391 Final Inspection 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 -0010 throug e A R 952 - 001 -0080. You may o btain copies of these rules or direct questions to OUNC by . calling (503)24 t Issue By: Permittee Signature. 0 00 -- _ /� Call (503) 639 -4175 by 7:00 P.M. for inspections n_ -d the next business day • Plan Check # CITY OF TIGARD Mechanical Permit Application Rec'd By 13125 SW HALL BLVD. Commercial and Residential Date Recd -> TIGARD, OR 97223 Date to P.E. (503) 6394171, x304 Date to DST Permit #( // 4/ 9"ddSY3 Print or Type Incomplete or illegible applications will not be accepted Called Name of Development/Project Description / Table 1A Mechanical Code Qty Price Amt _ Job Street Address Sude# A) Permit Fee ` . ' ° .� , . ..;, 16.00 1) Furnace to 100,000 BTU Address /a e/ - 5Q - 2 2/1417",-,?.?,o2 including ducts & vents see footnote 1,2 9.65 Bldg# City /State Zip 2) Furnace 100,000 BTU+ /r _ eg ?7Se including ducts & vents see footnote 1,2 12.00 Na or name of busines 3) Floor Furnace Owner G9 ' 4� k . 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 / / SGCJ e i do a 5) Vent not included in appliance permit 4.75 City/ tate n Zip Phone Check all that apply: *Boiler Heat Air 1 9722,2© -85eo For items 6 -10, see or Pump Connd Qty Price Amt Nor 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 N ame 9) 30 -50 HP; absorb Contractor unit 1 -1.75 mil BTU 36.00 , 2? "</i-...5,-6-40?--A r 10) >50HP; absorb unit Prior to permit M g Address >1.75 mil BTU 60.15 issuance, a copy /2' Zi9X ' 2 / ' 11 Air handling unit to 10,000 CFM of all licenses C tate Zip - Phone 7.00 are required if f, a92 %7Z`f 3/7$5 73 12) Air handling unit 10,000 CFM+ expired in COT Oregon Const. Cont. Board Lic -# I� f xp. ate 11.85 • database /3s 3 5 / a/ f ZD 0.# 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 Repair 0 Replace with like kind: Yes O No 0 18) Commercial or industrial type incinerator Residential Commercial 0 48.25 19) Repair units Additional information or description of work: 8.40 sQ � - 20) Wood stove /gas FP /other units /clothe dryer/etc. tc/95 -Fpei",__ V 7.00 7 JO NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets structural gas talcs. See footnote 1 1 3.75 3.75 Type of fuel: oil 0 natural gases- LPG 0 electric 0 22) More than 4 -per outlet (each) - .75 Minimum Permit Fee $50.00 SUBTOTAL mir, ,; VI SO 'I< I hereby acknowledge that I have read this application, that the information 8% SURCHARGE g•? U!,, i', a A ' f d 0 given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL ,`"£° IN Required for ALL commercial permits only.,, gb_, the owner, that plans submitted are in compliance with Oregon State laws. , TOTAL .� ^,, G 6 Signature of Owner /Agent Date // Other Inspections and Fees: �� - /Z - s� 1. Inspections outside of normal business hours (mininum charge -two C. - - r -rson Name Phone hours) $50.00 per hour 2. Inspections for which no fee is specifically indicated (minimum , .0 4.f lc - de 3l7 55 7' 3 charge -half hour) $50.00 per hour Foonotes for co mercial 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 1:\mechperm.doc rev 7/19/99 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ,� BUP Date Requested �A PM BLD Location /04( 9/ S r-✓ ,La d /7? 4 V/ Suite MEC /( GUS qy Contact Person Ph 3/ 7 ,SS 73 PLM Contractor Ph SWR BUILDING p _ Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation W"" / Drywall Nailing � ��w /ti % /L / �/` Firewall Fire Sprinkler �� I/� f 1� 0 r/4" 11 ' a AUPPPAIPW I l _ow 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 PART FAIL MECHANICA ° Post earn Gas L' Smoke Dampers Final PASS A FAIL 'ELECTR L=° �. ,.. • 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 ACA pr Approach /Sidewalk Date 1 2-1 o f Inspector 19t7 �/ Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.