Permit CITY OF T MECHANICAL
�9,,,i , DEVELOPMENT SERVICES PERMIT
a���'I' PERMIT # : MEC98 -0009
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 01 / 07 / 98
PARCEL: 2S102BD -01503
SITE ADDRESS...: 12750 SW PACIFIC HWY
SUBDIVISION • FREWINGS ORCHARD TRACTS ZONING: C —G
BLOCK • LOT •001 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP.. :B2 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 1 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 HANDLI UNITS OTHER UNITS.: 0
FURN < 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Installation of boiler, or comp, or heat pump or air conditioner unit
to 3 hp.
Owner: FEES
ROSE GOSPODINOVIC type amount by date recpt
12770 SW PACIFIC HWY PRMT $ 25.00 DRA 01/07/98 98- 302340
TIGARD OR 97223 5PCT $ 1.25 DRA 01/07/98 98- 302340
Phone #:
Contract or:
ANCTIL SHEET METAL CO-
4320 N WILLIAMS AVE
$ 26.25 TOTAL
PORTLAND OR 97217
Phone #: 503- 281 -0752
Reg #..: 008897
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
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 lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
I L Issue By: 1� i4m !� i 1 / Permittee Signatur= . ileA4 / ////,;
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + ++
Plan Che
CITY OF TIGARD Mechanical Permit Application Recd By •
13125 SW HALL BLVD. Commercial and Residential Date Recd / -- 7 '
TIGARD, OR 97223 Date to P.E. ---
(503) 639 -4171, x304 Date to DST
Pemiit tlf LL�at • Print or Type Called
� �CqB - �9
Incomplete or ille • ible applications will not be accepted
Name of Development/Project (�? f" • 0,j J_.± %..:,; ., ' Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# # aO3 A) Permit Fee -0- -0- 10.00
Address IZZ c i L
Bldg# , ; City /State Zip 1.) Furnace to 100,000 BTU 6.00
ri2J) 9 1 2 including ducts & vents
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
including vent
City /State Zip I Phone 4.) Suspended heater, wall heater 6.00
• or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. ✓ 6.00 to co
to 3 HP; absorb unit to 100K BUT°
City/State Zip I Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU**
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
`` e y 15-30 HP; absorb unit. 5-1 mil BTU'"
Prior to permit Mailing Address 7 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy 321) ,d w1 L.eeiwits Ate 30-50 HP; absorb unit 1- 1.75mi1 BTU"
of all C� I Zip Phone e 10.) Boiler comp, heat pump, air cond. 37.50
are required sired red i f , OK- > 50 HPP ; absorb unit 1.75 mil BTU"
expired in COT Oregon Const Cont. Board Lic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database 39f11 [o
Architect Name 13.) 14on- portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer city /State Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential
Additional Description of work: 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property ( - •►GTZ
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
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 of Owner /Agent Date *SUBTOTAL `CC21
„ 1 ' _ b '9F 5% SURCHARGE /
--- N- . - o ct Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
as- z Si -0732_, TOTAL i 1(r/ / A 5
hmech mt.doc (rev 9 U *Minimum permit fee is $25 + 5% surcharge (/
- Residential A/C requires site plan showing placement of unit.
7)
T//SHEET L . I7 METAL CO
4320 N. Williams Avenue • Portland, Oregon 97217
(503) 281 -0752 • Fax (503) 282 -5722
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I 0 CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639-4171
l
Date Requested: / — c. 2 -'4 — c. 2 -'40 �� p — 9.. A.M. P.M. /\ MST:
Location: _ • .- 4 _ 41°P , A_ _ L BUP:
Tenant: i ! C Z / / ! I_ SSuuitpe: Bldg: MEC: ( 7e -- 6007
Contractor: A • 1 _ W � I Pho 2 / D 7 5) — PLM:
Owner: _e_. _ 4,. �.,, 'h.ne: 6 39- 0 79 ELC:
//_ :A .:'/ .J / 0.•m ,•I /// _.1 ELR:
/0 J Ate- / . Q -59 - SIT:
BUILDING LDG (con't) P _ ' ="i, i G VCHANICAL) ELECTRICAL SITE
Site Post/Beam Post/Beam .. . c y1 Cover /Service Sewer /Storm
Footing Roof UndFl/Slab _ - o :MO' Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved Approved A.proved Approved Approved
Appr /Sdwlk Not Approved Not Approved d' of Ap .ro - . / Not Approved Not Approved
-
FINAL FINAL - ,�':� -... . �i 1 FINAL FINAL
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CI Call for rei;z tion CI Reinspection fee of $ II required before next inspection CI Unable to inspect
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Inspector: C, Date: PG ff Page of
1
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: / l — — !O A.M. X P.M. MST:
Location: /2? 756 S GO � i BUP:
^ — LCT
Tenant: l C t- Suite: Bldg: MEC: W-(1007
Cont actor: . / _A _AIl it P hone: ( c L 0 -55�� PLM:
if
Owner: Phone: _ ELC:
# At ' 40 ; •° ' 4 # : 3o 44-71 ---)- i ELR:
W
at IT C's�� � � I SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam • os r : earn 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 Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved •pprov• Approved Approved
Appr /Sdwlk Not Approved Not Approved No • pproved Not Approved Not Approved
FINAL FINAL FINAL FINAL
O Call for reinspection 0 Reinspection fee of $ • required before next inspection 0 Unable to inspect
Inspector: Date: — Z P r 9$ Page of