Permit }`' CITY OF T I G A R D MECHAN I CAL
'SW DEVELOPMENT SERVICES PERMIT
����l'il�k�t��ij PERMIT # : MEC98 -0131
,_' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 _ DATE ISSUED: 04/15498
PARCEL: 2S1O1BC -01700
SITE ADDRESS...: 12450 SW KNOLL DR
SUBDIVISION • TIGARDIA TERRACE ZONING: R -4.5
BLOCK LOT.... ........ .:002 JURISDICTION: TIG
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.......: 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 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 < 1O0K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN ) =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Install furnace and gas piping.
Owner: FEES
CHARLES E DEFOE type amount by date recpt
182 SW CORRAL CREEK RD PRMT $ 25.00 DEB 04/15/98 98- 304972
SHERWOOD OR 97140 SPCT $ 1.25 DEB 04/15/98 98- 304372
Phone #: 697 -4280
Contract or:
ARROW MECHANICAL
10330 SW TUALATIN RD
$ 26.25 TOTAL
TUALATIN OR 97062
Phone *: 692 -1565
Reg #..: 000051
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in• accordance with Heating lint • I n s p
approved plans. This permit will expire if work is not started ' M i sc. Inspection
within 180 days of issuance, or if work is suspended for more Final Inspection
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 . / .�.!.i l , Permittee Signature: 1 .410/11111110,1
V
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++i+++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Che
CITY G► ; TIGARD Mechanical Permit Application Rec'd By
131 SW HALL BLVD. Commercial and Residential Date Rec'd y - / 7- K
TIGARD, OR 97223 Date to P.E.
(503) 639-4171,.x304 • ... Date to DST
• Permit # f
Print or Type '1 E- e..0g- +G7/5'/
Called
Incomplete or illegible applications will.not be accepted
Name evelop tt /Prolect ' Description
e io E Table IA Mechanical Code QTY PRICE AMT -
Job Street Address �, Suite# A) Permit Fee -o- -0- 10.00
Address 434-5r) &kW 41/C •
Bld City/State zip B) Supplemental Permit 3.00
e or nam of business) 1.) Furnace to 100,000 BTU t 6.00
Owner C- de r a f incl. ducts & vents I
V Add ss,, Co f�� a t 2.) Furnace 100,000 BTU + 7.50 -
�, t t incl. ducts & vents
city t o /� Zip ,+, ,, Phon gq� 1 3.) Floor Furnace 6.00
04 Y2✓° 04 740 & I.' <' , . incl. vent
Name (or name of busiin 4.) Suspended heater, wall heater 6.00
• UL) or floor mounted heater
Occupant Mailing Address 5.) Vent not incl. in 3.00
appliance permit _
City /State , Zip Phone 6.) Boiler or comp, heat pump, air cond. - 6.00
to 3 HP; absorp unit to 100K BTU
Contractor Name A �� ^i n n �.. - 7.) Boiler or comp, heat pump, air cond. 11.00
(Prior to /` / ��r�( (�"�' UV / �� • 3-15 HP; absorp unit to 500K BTU
issuance Mailin Address 8.) Boiler or comp, heat pump, air cond. 15.00
applicant ,fe�'7/ % � ' f� ‘ 15-30 HP; absorp unit .5-1 mil BTU
must provide all CiN4State Zip Ph ne 9.) Boiler or comp, heat pump, air cond. 22.50
contractor / 09 vez 6$ -4- s 30-50 HP; absorp unit 1 -1.75 mil BTU
license Oregon Co t. Cont. Board Li Boiler or comp, heat pump, air cond. 37.50
information e_ )/ '7 Boarc. Exp. Date 10.)
'3 > 50 HP; absorp unit 1.75 mil BTU
for COT COT Business Tax or Metro # Exp. Date 11.) Air handling unit to 4:50
database). 10,000 CFM
Architect Name VA 12.) Air handling unit 7.50
10,000 CTM + or Mailing d 13.) Non portable 4.50
evaporate cooler
Engineer . City/State Zip Phone 14.) Vent fan connected 3.00
to a single duct
Describe work New 0 Addition 0 Alteratiory Repai 15.) Ventilation system not 4.50
to be done Residential 0 Non - residential 0 included in appliance permit
Additional_ Description of work 16.) Hood served by mechanical exhaust 4.50
17) Domestic incinerators 7.50 •
Existing use of p CS�r 18.) Commercial or industnaltype 30.00
building or property 5; incinerator
19.) Repair units 4:50
Proposed use of 20) Woodstove 4.50
building or property
21) Clothes dryer. etc. 4.50
Type of fuel - oil 0 natural gaPt PG 0 electric 0 22) Other units (,,) glcaH 97tri'LS ej 4.50
17(ta ae Qu E S al-- t .u.o ` �t �i�
I hereby acknowledge that I have read this application, that the 23) Gas piping one to four outlets 2.00
information given is correct, that I am the o , er or authorized agent of
the owner a is submitted are i i nce with Oregon State 24) More than 4 -per outlet (each) .50
� j
la . i/ - 3 `�'� - �
Signatureiof Owne - Agent i Date QTY.SUBTOTAL A-�°
n 8,7/ � .CNa 'SUBTO TAL
Contact Person Name 1 Phone 5% SURCHARGE l' 61 *
-f PLAN REVIEW 25% OF SUBTOTAL //�
�CP' " "
•
TOTAL
is \dst\mechpmt.doc (rev 7/96) "Minimum permit fee is 525 + 5% surcharge
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
.24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested c.1-'"2 / AM PM BLD
Location f ?_ L/c(` :7 - Suite MEC 9'S"'- >3
Contact Person Ph PLM ,' C-0
Contractor Ph SWR
BUILDING a , Tenant/Owner ELC (�I
Retaining Wall $. ELR r�
Footing Access:
Foundation FPS
Ftg Drain SGN
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
PAS3 PART FAIL
Post & Beam
Under Slab
Top Out
•
Water Service 4 0
Sanitary Sewer
• • ains
ASS - • =• FAIL
!} ECHANI t, ,>
Est . Beam
Rough In
Gas Line
Smoke D mpers `
ASS PART AIL
ELECTRICAL; w , a `
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
ADA
Approach /Sidewalk
Other Date r? s-- 21-- 9 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.