Permit w
1, CITY OF T MECHANICAL
/4�r� DEVELOPMENT SERVICES PERMIT
. a � � — 5 SW HaII Blvd., Ti 1 312 ard, OR 97223 503) 639.4171 PERMIT # • MEC98 - 0521
Tigard, ( DATE ISSUED: 11/18/98
PARCEL: 1S136DB -02400
SITE ADDRESS...: 11644 SW PACIFIC HWY
SUBDIVISION • ZONING: C —G
BLOCK • LOT • 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/O 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.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Chaepion - oil furnace to gas replacement
Owner: FEES
BOBBI CHAMPION type amount by date recpt
2046 SUNRAY CIR PRMT $ 25.00 JSD 11/18/98 98- 310920
WEST LINN OR 97068 5PCT $ 1.25 JSD 11/18/98 98- 310920
Phone #:
Contractor:
SPECIALTY HEATING & FABRICATIO
9528 SW TIGARD ST
$ 26.25 TOTAL
TIGARD OR 97223
Phone #: 620 -5643
Reg #..: 006657
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Heating Unt Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-0014010 through OAR 952-0014080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
IP
IOW .� /� ,���� v` ,--
Issue :, `� Permittee Signati.:re:
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Call 639 -4175 by 7 :00 p.m. for inspections needed the next business —_
T + ++ ++ ++ +++ + + + + ++ + + + + + + + ++ + + + + + + + + + + + + + ++ + ++ + + ++ + ++ + ++ + ++ + + + + + + + + + + + + + ++ + + + + ++ +
•
Plan Cher #
...CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd // /C5 r
TIGARD, OR 97223 Date to P.E. .
(503) 639 -4171, x304 Date to DST
Print or Type Permit # /,WC9g -pse/
Inc() lete or illegible applications will not be accepted Called 077---
Name of Developmen Description • •
Table 1A Mechanical Code Qty Price Amt •
•
Job Street Address ' Sude# A) Permit Fee t, rka ,1,4' 1 0.00
/ 1 /
Address C� f o' rA-c 1 4,...49 4,...49 1) Furnace to 100,000 BTU including ducts & vents ( 6.00
Bldg# ' City /State MP 2) Furnace 100,000 BTU+
including ducts & vents 7.50
Name (or name of business)) '' 3) Floor Furnace
Owner j o rl i3 i C. i'T a ill e / or/ including vent 6.00
Mailing Address 4) Suspended heater, wall heater
/�s' m
^2o �67 -004 v7 e- //L 5) or Vent Floor not included ounted in appliance heater permit 6.00
City /State Zip Phone 3.00
ire 7 1-/Avy• 0 it °) 6 4S6 - SSA CHECK ALL Toiler Heat Air
Name (or name of business) THAT APPLY: or Pump Cond Qty Price Amt
Comp
6) <3HP;absorb unit to
Occupant Mailing Address ' . 100K BTU 6.00
7) 3-15 HP;absorb unit .
City/State Zip Phone 100k to 500k BTU 11.00
• 8) 15 -30 HP; absorb .
Contractor Name unit .5 -1 mil BTU 15.00
r 9) 30 -50 HP; absorb . •
.l 0 0 0 l a I IN i -!• f'1 iii unit 1 -1.75 mil BTU • 22.50
Prior to permit Mailing Address • 10) >50HP; absorb unit
issuance, a copy 9 flax S Ltd I j - a t ,4 ,5 >1.75 mil BTU 37.50
of all licenses S.itgistate J Zip Phone 11) Air handling unit to 10,000 CFM •
are required if ( / r. ►Ord Of ' 9 7 Ti /- `,5 /u4 G 4.50
expired in COT oreggyConst. Cont. Board Lic.# ate I 12) Air handling unit 10,000 CFM+
database 4., L 57 g it (g� 7.50
Architect Name 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 Phone appliance permit • 4.50
16) Hood served by mechanical exhaust •
Describe work to be done: 01 L f l,(ZN/itE r 4
4.50
f' lu'e ' .7) Domestic incinerators .
New 0 Re air 0 Replace with like kind: Yes 0 Nom 7.50
Residential Commercial 0 18) Commercial or industrial type incinerator •
30.00
Additional information or description of work: 19) Repair units - .
4.50
20) Wood stove • •
4.50
- 21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gasX 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 P 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 ,{-f&::% k
(� �J� �7 Minimum Permit Fee $25.00 SUBTOTAL ` // ne
" �� //'%V (/�� /�'% / /�! ��� 5% SURCHARGE *il . t �- f '
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL k
� Required for ALL commercial permits only � � ,'-
(7, / 0 / 3 I .
TOTAL , :^ " . � 5
'State Contractor Boiler Certification required •
"Residential A/C requires site plan showing placement of unit .
I: lmechperm.doc rev 07/20/98
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUD
/6.23 Date Requested �i �,� / �I� � �/T AM X BLD
Location // / (p 1 Pi Sa) v 6
Suite MEC 52
Contact Person �iLQ(L.L r 4, Ph PLM
Contractor ,i i << _ Ph � �'��O 4/3 SWR
BUILDING Tenan / Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear CD A je—.1—Z „rsz_12-/2_44.4Z,
Framing
Insulation
Drywall Nailing -
Firewall 1 „ , or
Fire Sprinkler
Fire Alarm
r Susp'd Ceiling / AVM t
Roof
Misc:
Final
PASS PART FAIL
PLUMBING lam. et-‹ \t . 3 GZ�35
Post & Beam
Under Slab •
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ECHANI
0
�Rou h In
Gas Line
Smoke Dampers
Final
PASS 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 t `�j
Other D ` ` 1 Il Inspector C A
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.