Permit „...
CITY OF T MECHAN I CAL
' 4, DEVELOPMENT SERVICES PERMIT
�IP61 PERMIT # - MEC`�8-0059
.tfr k... 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 02/19/98
PARCEL: 1S133DD -05100
SITE ADDRESS...: 11494 SW LAKEVIEW TERR
SUBDIVISION....: VILLAGE AT SUMMER LAKE PARK 3 ZONING: R -4.5
BLOCK........... LOT. ............: 090 JURISDICTION: T I G
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/O APPL: 0 VENT SYSTEMS: 0
STORIES........: 0 BOILERS /COMPRESSORS HOODS.......: 0
FUEL TYPES 0 -3 HP - 0 DOMES. INC IN : 0
:GAS 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 : 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 1
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN ) =100K BTU: 0 ) 10000 cfm: 0
Remarks : Installing gas line and gas logs
Owner: FEES
BOB RACZKOWSKI type amount by date recpt,
11494 SW LAKEVIEW TERR PRMT $ 25.00 B 02/19/98 98- 30343E
TIGARD OR 97223 SPCT $ 1.25 B 02/19/98 98- 303436
•
Phone #:
Contract or:
A & A HEATING & COOLING
P.O. BOX 1266
$ 26.25 TOTAL
SANDY OR 97055
Phone #:
Reg #..: 000870
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line I.n s p
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection
applicable laws. All work will be done in accordance with Final Inspection.
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. . ______
. _______ ___ . _
_____
- y
Issue By: Per mittee Signature: , :� A
++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + +- 1- + + + + + + + + + + + ++ + +, + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + +++ + +-I- + + + + + + + + + ++
FEB -18 -98 WED 09:52 PM B RRCZKOWSKI 503 452 9426 P.01
RECEIVED
Lie :0/97_ T)IU 10 :68 FAX soa 59a laao .._._... CTTY.oF. ..TTGARA, ,_ _.. . .. _��� ,., •
: . FEL= �'f.1998 �,
. mod . . . .. rl;ttt t:it.•c' ri IJ �) ✓
CITY OF TIGARD Mechanical Permit Appi ulfttbOitl DEVELOPMENT R"`- R"`- d r ._.7.� / Fot
13125 SW HALL BLVD. . -. �., : Commercial and Residential : . Dgt,'.,:,:(i • _. -,--
TIGARD, OR 97223:. Date !o 2..
., ,
,.;, Date t rJ�;'!
(503) 939 -4171, x304 , Pr an;t t - 'db
Print or Type M -
C,t'lnc
Incomplete or illegible applications will not be accepted
' Named OOeveiopr iM 1G�s t Clest ipbon
Table 1A Mechanical Dade C T r 1 !"Fac:.. I Ak,t
Job Sweet acydioti, Sang A) Permit Fee ,_ _.. -�7:. -, i- ;tl ,i)
Address i I (19' . w 1.toKEVjFw 7E4 w_., k.. ._
1' 60/State B1doit 60/State IV .1.) Furnace to 100,000 BTU " T i ., . ;i �� ,
Tja -- oK.. ?7aa3 Including du4S $ -Vents . I___
- - . Name (or name of business) ( 2.) Fumace 100.000 BTtJ+ j 5� ; I
Owner 7?AC a tow 5K1 Ildut3ing ducts & vents 1 1
Maitin9 Address 3.) Floor Fumace j ':cv 1 1
4-0a6 1.w V �
R�N 57 /4 IncnGtttrdingvent - - -.._ I
o to
CiteStai Phone 4.) 61p heater, wall heater i - ,-, CO �-
Po 1=�t 1� , orb y>a> 9 ySa'�9$ ortioor mounted heater ,.,_._...,. - ....__ !
Neale for name of cliches$) 6.) Vent not induded in appliance permit I A j " �_ „-
Occupant Mailing Address 8.) Boiler or comp, heat pump; air cond. .vii .c i
to 3 Hl; absorb unit to 100K BUI'- _..._ ._ -- . .,.-_.-.,.,. '
city/slate 40 _ Rhona 7.) Boiler or comp, heat pump, air cond. i v.r1J - i
• 3.15 HP absorb unit to 600K BTU`" I . --- --_. �•,,..�!
Contractor tame a.) Boiler or comp, heat pump, alr cond. ;.C,_t {
o-sty oJt.LE1 257115 6/ PI Q/NC
15,30 HP; absorb unR,,•S mil BTU' i
tivt A 9.) Boiler ormm heat ptim al cord. .._. .. - - --
Prior to permit 9 ) p, p, 1
issuance, a copy 1, ,.19 /b � 7 L9 3450 HP: absorb Unit 1- 1.75mli E1'..r ._. J •
of all licenses /state -, Zip Priam 10.) Boiler or Comm heat pump, air cond. I • � : t i
are required if ��/� ' C.VJ L _ - eG . 50 HP: absorb untt 1.75 mil BTU*" . __ _ _ . . ... _ J _ _ L .. _. _
O regon Cons/ Cant Bearq t .ic,a E�yl 11.) Air handling unit to 10,0 C FM f
expired in COT _ `t '"
database C'iC 1 OJ I' 3 �n - -... F 1
Architect Wirr4 13.) Non - portable evaporate cooler I j 1 , .Q
or Mailing Address 14.) Vent fan connected toe single duct - - - -. - -; .__ 7o i
cifJristate - a) Ventilation systim not inducted in - � y 4 - -�
Engineer Phone
Appliance permit • w
Describe work New 0 Addition Q Alteration re Repair 0 16.) Wood served by mechanical exile our i 4. L,; i
to be done Residential 0 Non - residential 0 _ _ 1
Additional Description of work: 17.) Domestic& incinerator* • ;■t
= .141" - /NG �i4 t t G e..06 A. .o4 s - 7c& EXiS7
18.) Commercial or industrial type
Fraf, t/+c.E , In �
etnerr _, _ I i -
Existing use » of 9.) Repair units
i
building or property � / l C- g_•
. 20.) Wood stove 4.!...:0
Proposed use of 21_) clothes dryer. eta { a. w0 ,
t
building or Property
22..) Outer units :i P y
l E
- Type of fuel - ail O natural gas V' t-PG, O electric O 23.) Gas piping one to four outlets , ? i ;(1
I hereby acknowledge that I have read t - appgtaation, that the 243 Marathon 4-per outlets (each) 00
Information given la correct. that I em the owner or authorized agent of `
the owner, that plane submitted are In compliance with Oregon State QTY_ SUBTOTAL, .Z�j�
taws. j _ -
Signature of Owne - gent Date '"SUBTOTAL, _. I • - i -- M
•
° 0-43-2g q 5% SURCHARGE; _; ^ � ` - 2 . �
O
Contact-Person-Name Phone - - PLAN-REVIEW-25% OF- SUSTOTAI - - - - - 7:17_ _ - -
"go. TOTAL .- .AtZ
1:lrrtech .doc lieu - 7 - *M n trnun permit fee is $25 + 5 ak surcharge
'Res1dentiai A/C requires site plan showing play.' +'I...•: -s
2- - e :ate C Is,f r --fD
11 CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: vZ - 9 d 40 x 7 < _P.M. MST:
Location: ! e t 1 t 0 ' Am. 1 t' 1 / -.._ �` / J • o f BUP:
Tenant: Suite: Bldg: MEC: lc/Y-69-51'
Contractor: _ �� • ? � . —411 s -!1L(� �-1., Phone: 7 - t4 7 Met., Q,, PLM:
Owner: • / Phone: , LiSZ 06?" Par- ELC:
. . 1 .' i Or ', r 1 j ELR:
lFi ' 11 P'
SIT:
B ) ING BLD I con't) PLUMBING CHA.NICAL ` ELECTRICAL SITE
Site Po : . Post/Beam os eam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line . Rough -In UG Sprinkler
Foundation Insulation Sewer H• ` �..,. Reconnect Vault
Bsmt Damp Drywall Storm FP �� emp Service MISC.
Masonry Ceiling Rain Drain • C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved . _: A' 'rov• . Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL. F INAL FINAL FINAL
t
("' % kis' 445 d•-es 4 L i' /-, ,, S r9ga:t e "= 2-4.:,
r j. AA-c- c_ 14-A.-- - 1 b...rL A e. 72 cy c lC�� /r.., O." y et :V o A.>
C] -Call for reinspec ' " - C] Reinspection -fee of-$— - required before,neext inspection - -- - CI Unable to- inspect— - -- - - -
Inspector: " Date: � �` - / C Page of