Permit CITY OF T MECHAN I CAL
i4<,aef DEVELOPMENT SERVICES PERMIT
. , 11, li i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # : MEC97 -0330
DATE ISSUED: 09/04/97
PARCEL: 2S104BA -16100
SITE ADDRESS...: 13696 SW LIDEN DR
SUBDIVISION • CASTLE HILL NO.3 ZONING: R -12 PD
BLOCK • LOT •191 JURISDICTION: TIG
CLASS OF WORK..:ADD 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 : 1 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.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Installation of of gas line and 150,'.'. BTU swimming pool heater.
Owner: FEES
BOB LIBBY type amount by date recpt
13696 SW LIDEN DR PRMT $ 25.00 DRA 09/04/97 97- 298928
TIGARD OR 97223 5PCT $ 1.25 DRA 09/04/97 97- 298928
Phone #:
Contractor:
CLASSIC POOL & SPA
17875 SE 82ND DR
$ 26.25 TOTAL
MILWAUKIE OR 97220
Phone #: 653 -8010
Reg #..: 000606
REQUIRED 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 Unt Insp
approved plans. This permit will expire if work is not started Misc. 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- 801 -0010 through OAR 952- 001 -0080. You lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
C Issue / l� I L ' Permittee Signatu - cr
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + +++ + + + + + + + + + + +++
Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + ++ + + + + + + ++ + + + + + + + ++
Plan Ch
CITY OF TIGARD Mechanical Permit Application Recd By i 0 .
13125 SW HALL BLVD. Commercial and Residential Date Recd 9 -4-9 7
TIGARD, OR 97223 Date to P.E• -, -
(503) 639 -4171, x304 Date to DST_
Print or Type Permit # H9(97 -c
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description - -
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address 1_369 L ARA
Bldg# City /State Zip 1.) Furnace to 100,000 BTU 6.00
T,q� t � IL WO O " including duds 8 vents
N e (or name b in 1 2.) Furnace 100,000 BTU+ 7.50
U
Owner including ducts 8 vents
Mai Address y 3.) Floor Furnace 6.00
C j (� yVI SZ including vent
City Zlp Phone 4.) Suspended heater, wall heater 6.00
or floor mounted heater
N for reme of iti fin ) 5.) Vent not included in appliance permit 3.00
Occupant Mail Address b J 6.) Boiler or comp, heat pump, air cond. 6.00
�>n to 3 HP; absorb unit to 100K BUT"
City/ s Zip I Phone ; 7.) Boiler or comp, heat pump, air cond. j 11.00 11 CO
3-15 HP; absorb unit to 500K BTU" ,
Contractor Na " 1 e - - 8.) Boiler or comp, heat pump, air cond. 15.00 41)) (Prior to li 05 S) < I 15-30 HP: absorb units -1 mil BTU"
issuance Meiling Ada �, 9.) Boiler or comp, heat pump, air cond. 22.50
applicant ' 5t_ r 30-50 HP; absorb unit 1- 1.75mil BTU"
must provide all r/ to v gyp' W00();1 - Exp. Dale 10.) Boiler or comp, heat pump, air cond. 37.50
contractor n I 0 5 ' NA > 50 HP: absorb unit 1.75 mil BTU"
license Oregon Consc Cont. so r 11.) Air handling unit to 10,000 CFM 4.50
information if / ! \ ( ^ /
expired in - rV l) �O J _
COT COT Business Tax or Met Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database).
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
•
Engineer cnyrstate Zip ` Phone 15.) Ventilation system not included in 4.50
I appliance permit
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0 S
Additional Description of work 1� � / O �\ O � 'r 0 17.) Domestic incinerators 7.50
i ,/ LJ V
0 L l (� (�S I e ion O f y.,J 0 Nn ),, e 1 p V Ol k C 1 8.) Commercial or industrial type 30.00
" Incinerator
Existinouse of' 19.) Repair units 4.50'
building or property i
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas' LPG 0 electric 0 23.) Gas piping one to four outlets 2.00 O(
e
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
•
laws.
Signature HAgent Date *SUBTOTAL ��
C C ) �.I � - q ..� ---/ 5% SURCHARGE
Contact P eonNam ��
Phone ' PLAN REVIEW 25% OF SUBTOTAL `�
J 7nil (5.) C. pRr S l 123 TOTAL 2■ "
i:\dst�rnechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge U
"Residential NC requires site plan showing placement of unit.
Page No. 1 CASE HISTORY FOR CASE NO.: MEC97 -0330
BOB LIBBY
13696 SW LIDEN DR
•
12/29/98
Action Description Req/ Schd/ End/ Action Notes Disp Update Upd
Code Sent Done Done Date By
- --- --- -- - ----- - --
MECA007 Application received / / / / 09/04/97 PASS DRA 09/04/97 DST
MECA008 Create Permit / / / / 09/04/97 PASS DRA 09/04/97 DST
MECA060 (F) Issue permit / / / / 09/04/97 PASS DRA 09/04/97 DST
MECA705 Gas Line Insp 09/04/97 / / 09/12/97 30 psi PASS KS 09/16/97 J *H
MECA799 Final Inspection / / / / / / refer to bup97 -0339 for final inspection 09/19/97 JT
MECA799 Final Inspection /' / / / 01/26/98 Approved as noted: PASS KS 01/26/98 J *H
Pool heater not covered at this time.
MECA800 Case Finaled / / / / 01/26/98 ' PASS KS 01/26/98 J *H
•