Permit CITY TIGARD MECHANICAL PERMIT
l DEVELOPMENT SERVICES PERMIT #: MEC2000 -00305
' V II I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/28/00
PARCEL: 1S134AD-01700
SITE ADDRESS: 11373 SW LAKEWOOD CT
SUBDIVISION: ENGLEWOOD ZONING: R -4.5
BLOCK: LOT: 057 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replacement gas furnace.
Owner: FEES
JADIN, JAMES POWELL Type By Date Amount Receipt
11373 SW LAKEWOOD CT PRMT GWL 7/28/00 $50.00 0004045
TIGARD, OR 97223 5PCT GWL 7/28/00 $4.00 0004045
Total $54.00
Phone:
Contractor:
AAA HEATING + COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 284 -2173 Final Inspection
Reg #: LIC 00000222
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 through OAR 952 - 001 -0080.
You may obtain copies of these , rules or di rect questions to OUNC by calling (503)246- 9189. -- --
Issue By: C�� n /jU Permittee Signature:
V
all (503 639 -4175 by 7:00 P.M. for inspections needed the next business day
CIS OF TIGARD Mechanical Permit Application Plan Check #
P P Recd By u i
13125 SW HALL BLVD. Commercial and Residenti ECEIVED Date Rec'd 1 Zv - CPC
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 (V l 9 JUL 2 0 2000 Date to DST
\ Print or Type QM Icy Permit #W\ t'C 2 9dd - (603
Incomplete or illegible applications w ill no b e accepted not •
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Via
Job Street Address Suite# A) Permit Fee :'`;`, 16.00
Address 1 3`'3 SW L.AI J WOOb CT. 1) Furnace to 100,000 BTU
Bldg# City /State Zip including ducts & vents see footnote 1,2 1 9.65 ` '.
2) Furnace 100,000 BTU+
TIGAr2D,o, . G including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace - ,
Owner 01 Wl 0 -1 M including vent• see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
I I 3-73 � �� �� or floor mounted heater see footnote 1,2 9.65
5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
6Al2-7 , aa, 6 1 . 2.22. - - 3 %o For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1 „2 Comp
6) <3HP;absorb unit to
U 1111 JA t3 100K BTU 9.65
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Occupant Mailing Address 7) 3 -15 HP;absorb unit
I 1 313 5Lt LAKE-coon t)on C.T . 100k to 500k BTU 17.65
City/State Zip Phone 8) 15 -30 HP; absorb
Tc&FIR.D , 01.2, q 1 1 2.x . 3 560_31160 unit .5- -1 mil BTU 24.15
Contractor Name 9) 30 -50 HP; absorb
AAA I - -i i J& f COL 1 m cr 10) 1-1.75 0HP mil BTU 36.00
10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy o -e1(5 ikj E (VILIC- 11 Air handling unit to 10,000 CFM
of all licenses City /state Zip Phone 7.00
are required if f ,City/State 9 - 0-1 2, 4 3 12) Air handling unit 10,000 CFM+ •
expired in COT Oregon Const. Cont. Boa ic:# Exp. Date 11.75
database Oc) a .9-9 / �} t` to-2_3-0 I 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 .. No 0 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 calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas ® LPG 0 electric O 22) More than 4 -per outlet (eac .75
Minimum Permit Fee $50.00 SUBTOTAL ram ; y; 50.00
I hereby acknowledge that I have read this application, that the information I ,6% SURCHARGE a f :., 4,00
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL 7
the owner, that plans submitted are in compliance with I -.on State laws. Required for ALL commercial permits only ,,.,.,, °
TOTAL `J` ' 5 4.00 Signat� -- - wner /A• - • Date >�
,r o -7 1 g _c o Other Inspections and Fees:
1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name Phone hours) $50.00 per hour .
gLi _ai . 2. Inspections for which no fee is specifically indicated (minimum
J _ 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:\mechperm.doc rev 02/4/99
f CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 - Business Line: 639 -4171
BUP
Date Requested / AM PM BLD
Location 1/) 7,3 Y & 4 4, d c-/ Suite MEC Zo04 a G G 3 oS
Contact Person Ph 51O 3 G PLM 41 ,
Contractor Ph 0 2 g /-Z ����
/ 73 SWR !!�
Lt�
BUILDING' : x „a' -° ,” : °x, a Tenant/Owner ELC
Retaining Wall ELR •
Footing Access:
Foundation /' j r's r r — �/f � c.,-6.•-,d /44-key-t....41- FPS
Ftg Drain [' / V rr> GN
Crawl Drain Inspection Notes:
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
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CHANICA
Post & Beam
Rough In
Gas Line
Smoke Dampers
1 PART FAIL
ELECTRICAL
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
Other Date - J 7 /Oa Inspector _ �"ti - Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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