Permit .....,.., CITY OF TIGARD MECHANICAL
� ��� DEVELOPMENT SERVICES PERMIT
.-'� ./i 13125SW Hall Blvd .,Tgard,OR97223(503)639 -4171 PERMIT # • MEC99 -0007
DATE ISSUED: 01/06/99
PARCEL: 1S134DB -07300
SITE ADDRESS...: 11100 SW NORTH DAKOTA ST
SUBDIVISION • TORLAND ESTATES ZONING: R -4.5
BLOCK • LOT :011 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: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =1O0K BTU: 0 ) 10000 cfm: 0
Remarks : Installation of gas fireplace in residence.
Owner: FEES
JULIAN TORLAND type amount by date recpt
11100 SW NORTH DAKOTA PRMT $ 25.00 DLH 01/06/99 99- 311981
TIGARD OR 97223 5PCT $ 1.25 DLH 01/06/99 99- 311981
Phone #:
Contract or:
T & K MECHANICAL
TIMOTHY S WYNNE
11525 SW CANYON $ 26.25 TOTAL
BEAVERTON OR 97005
Phone #: 626 -4652
Reg #.. : 001211
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 Final Inspect i o n
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.
Issue By: Permittee Signature: —,----
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
—.CITY OF TIGARD Mechanical Permit Application Rec'd By .2
13125 SW HALL BLVD. Commercial and Residential Date Rec'd /67g,
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 . Date to DST —
�
Print or Type Permit # rig 600
Incomplete or illegible applications will not be accepted called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 10.00
1) Furnace to 100,000 BTU
Address I / f 00 S L✓ •4JoNDl Ditri A including ducts & vents 6.00
Bldg# I City /State Zip 2) Furnace 100,000 BTU+
% t g. c9.I q 7243 including ducts & vents 7.50
Name (or name of business) 3) Floor Furnace
including vent 6.00
Owner Mu i ta - OrL<' -„'k 4) Suspended heater, wall heater
Address
ddress
- 1 or floor mounted heater 6.00
/// O0 5 a✓ /LJa r ' " DA K o f i4 5) Vent not included in appliance permit
City/State Zip Phone 3.00
77.7-4 or 1 7 71-3163 q-2435- CHECK ALL Toiler Heat Air
Name (or name of business) THAT APPLY: or Pump Cond Qty Price Amt
5 e-. ,---, Comp
Occupant Ma iling Address 6) KHP;absorb unit to
p l00k BTU 6.00
7) 3-15 HP;absorb unit
City/State Zip I Phone 100k to 500k BTU 11.00
8) 15-30 HP; absorb
Contractor Name unit .5-1 mil BTU 15.00
�am 9) 30-50 HP; absorb
1 (4 rife c ay„ C, ‹ unit 1 -1.75 mil BTU 22.50
Prior to permit Mailing Address 10) >50HP; absorb unit
issuance, a copy 2,0s4, S Sc/ /, (/ M...4' ir3 % . >1.75 mil BTU 37.50
of all licenses City /State Zip �� 11) Air handling unit to 10,000 CFM
are required if ,4LoW /f a) ( ,70.c. (y /9)j 4.50
expired In COT Oregon Const. Cont. Board Uc.# Exp. Date 12) Air handling unit 10,000 CFM+
database )2/(65 3/-20.2 7.50
Architect Name a/ % 13) Non - portable evaporate cooler
• 4.50
or Mailing Address 14) Vent fan connected to a single duct
3.00
15) Ventilation system not included in
Engineer City/State Zip I Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
Nev./0 Repair Replace with like kind: Yes 0 No 0 7.50
Residentiahf2L Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: �Nyi�I� ��Cg 19) Repair units
f
/i g---e- e / �� 4.50
�z47U G, ci 5 /7r Pt 2 0) Wood stove
4.50
Fro n7 1 / 21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural ga99., LPG 0 electric 0 22) Other units /
4.50
I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets
given is correct, that I am the owner or authorized agent of ' 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Signature of Owner/Agent Date
Minimum Permit Fee $25.00 SUBTOTAL A5,
( - 6 - ( 1 5% SURCHARGE i.
Co erson Nam Phone PLAN REVIEW 25% OF SUBTOTAL r..,
Required for ALL commercial permits only I
,1 Lc� vain
c ti/ t'`/ s' a ^ -C r' . `T 7 I TO TAL ‘•
'State Contractor Boiler Certification required
"Residential NC requires site plan showing placement of unit
1:1mechperm.doc rev 07/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
P Date Requested //7/ 'Y AM • PM BLD
Location / / /DD Suite MEC 9X007
Contact Person /gym / Ph (v Vi VY PLM
Contractor / i- I 0 41 1C Ph SWR
BUILDING Tenant/Owner J
. O A Ma.f y /a -41/4 ELC
Retaining Wall / ELR
Footing Foundation Access: FPS
Ftg Drain / / SGN
Crawl Drain Inspection Notes: r, • ,,
Slab iha__1 / La /Yl5pir -/r ' SIT
Post & Beam
Ext Sheath /Shear _ /�
Int Sheath /Shear ^ ' '� .cam/
Framing Ov l7
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
MECHANICAL
Post & Beam
Rou • •
P ampers
PART FAIL
E RICAL
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 �n1,
Approach /Sidewalk — Date Inspector , 1 I � nspecto C
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. .