Permit C ITY OF TIGARD MECHANICAL PERMIT
1I n DEVELOPMENT SERVICES PERMIT #: MEC1999 -00168
'�I � ! 131 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/26/99
PARCEL: 2S 102C B -03101
SITE ADDRESS:. 12950 SW PACIFIC HWY 3B
SUBDIVISION: FREWINGS ORCHARD TRACTS ZONING: C -G
BLOCK: LOT: 021 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 2
FURN > =100K BTU: < =10000 cfm: 2 GAS OUTLETS: 1
> 10000 cfm:
Remarks: Mechanical TI
Owner: FEES
MARILYN HENDERSON Type By Date Amount Receipt
JENSEN HUDSON TRUSTEE PRMT DST 4/26/99 $30.00 99- 314851
11795 SW KATHERINE ST PLCK DST 4/26/99 $7.50 99- 314851
TIGARD, OR 97224 5PCT DST 4/26/99 $1.50 99- 314851
Phone: Total $39.00
Contractor:
SUNSET PLUMBING
G LONG INTERPRISES INC
PO BOX 23263 REQUIRED INSPECTIONS
TIGARD, OR 97281 Gas Line lnsp
Phone: 245 -4926 Mechanical Insp
Reg #: LIC 120893
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other 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 in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtaincopi- •f the j_ rules or direct questions to OUNC by c- • g (503)246 -;89.
Issue By: /G� Permittee Signature: ta 1 I I lh
l Call (50 639 -4175 by 7:00 P.M. for inspections needed th ne xt business day
CITY OF TIGARD Mechanical Permit Application Recd By 6.-+
' 13125 SW HALL BLVD. Commercial and Residential Date Recd 4 1 - 16 - ff
TIGARD, OR 97223 Date to P.E. Li- ZP-1'
(503) 639 -4171, x304 • Date to DST Attk 71 t
Print or Type Permit # rAree °sa -col W
Incomplete or illegible applications will not be accepted Called 7- 4/ 9:/0
Name of DevAlopment/PTOd Description
P aVa �n..S Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 10.00
Address l agto sw ?ckei- t- kV 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 6.00
Bidg# City/State 7ip 2) Furnace 100,000 BTU+
Q,v Q is Z- including ducts & vents see footnote 1,2 7.50
Name (or name of business) j 3) Floor Furnace
Owner P":7 A mor ■ r -Cr�C including vent see footnote 1,2 6.00
Mailing Address 1 4) Suspended heater, wall heater
I Ct I �q � � { V ��� or floor mounted heater see footnote 1,2 6.00
1'1 J\‘-- 5) Vent not included in appliance permit
City/State 3 5200 Zip Phone 3.00
i ,r, r rr haffA A l Check all that apply: Toiler Heat Air
Name (or name of siness) / For Items 6 -10, see or Pump Cond Qty Price Amt
footnotes 1,2 Comp "
OCCU Occupant Mailing Address 6) <3HP;absorb unit to
P 100K 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
unit .5 -1 mil BTU 15.00
Contractor Name
Pim'-b;G I�Q 9 ) 30 -50 HP; absorb
u unit 1 -1.75 mil BTU 22.50
Prior to permit auin A�, ddress�16� 10) >50HP; absorb unit
issuance, a copy } ) ��(� �+ >1.75 mil BTU 37.50
of all licenses C' / a \( e ' (Jt �( ' Zip - Phone
are required if ► 14 C 11) Air handling unit to 10,000 CFM ) -3 0) g5-LQ) (Q ip 4.50 t
expired in COT Ore C$ nst. Cont. Board Licit Exp. Date 12) Air handling unit 10,000 CFM+
database J l a 0 gQ 3 3`1 -WOO - 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 I Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes 0 No 0 7.50
Residential 0 Commercial 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
4.50
20) Wood stove
NOTE: For Commercial projects only; Units over 400 lbs. require 4.50
structural gas calcs. 21) Clothes dryer, etc.
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 4.50
22) Other units /it
I hereby acknowledge that I have read this application, that the information v Vey X a 4.50 9 00
given is correct, that I am the owner or authorized agent of 23) Gas piping one to four outlets
the owner, that plans submitted are in compliance with Oregon State laws. See footnote 1 2.00
24) More than 4 -per outlet (each)
sign: re of Owner /A: - Date a[/S .50
,.P a �( , /r - i ,# - / , 9 /a Minimum Permit Fee $25.00 SUBTOTAL �i /, 0.-. on.,r'erso;14a " , Phone ���� �p
` f 1R //�� t ) : � - \� 5% SURCHARGE I y /�i ( J��J PLAN REVIEW 25% OF SUBTOTAL . �p
Foonotes for commercial • . " i is only: Required for ALL commercial permits only • 7J_
1. Provide full schematic o • .' -ting and proposed gas line and pressure. TOTAL
2. Provide drawings to scale showing existing and proposed mechanical f
units. *State Contractor Boiler Certification required
"Residential NC requires site plan showing placement of unit
I:\mechperm.doc rev 02/4/99
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6/29/99 Activities for Case #: MEC1999 -00168 '
12:38:59 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 APPlication received 4/16/99 GEO RECD No Hold BON 4/20/99
MECC008 Permit created 4/20/99 BON DONE No Hold BON 4/20/99
MECC011 Routed to Plans Examiner . . 4/20/99 BON DONE No Hold BON 4/20/99
MECC014 Plan checked /Approved by P.E. 4/21/99 4/21/99 4/21/99 RDP DONE No Hold RDP 4/21/99
MECC015 Reviewed Plans Routed to DSTS 4/21/99 RDP DONE No Hold RDP 4/21/99
MECC705 Gas Line lnsp 4/21/99 4/21/99 4/27/99 TLP PASS No Hold AKJ 4/27/99
MECC706 Mechanical lnsp 4/21/99 4/21/99 No Hold RDP 4/21/99
MECC016 DST Post - Review Completed 4/26/99 BON DONE No Hold BON 4/26/99
MECCO50 (F) Ready to issue 4/26/99 BON DONE No Hold BON 4/26/99
MECC090 (F) Issue permit 4/26/99 DST DONE No Hold DST 4/26/99
MECC799 Final Inspection 5/24/99 5/24/99 5/12/99 TLP PASS No Hold AKJ 5/24/99
MECC800 Case Finaled 5/24/99 AKJ DONE No Hold AKJ 5/24/99
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP G ] , q - � (7(� 3
Date G Requested 5- I Z- ( g I AM ( ,/PAM BU IctgCI. -001( c
Location � 2- v�) �6L - ' Suite 36 MEC I qRq - Oaf --�
Contact Person p' 1�� ' ti ' J 1. Ph S/ /'l yZ] PLM
Contractor Ph SWR
�UILDI G en Owner P� (f oLi / S ELC
Retaining Wall ELR
Footing Access: 'w ��
Foundation ELL 19, qq -Rr k � � FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam �
Ext Sheath /Shear mt cbl 9
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
((IECHAI1ICD
Post & Beam
Rough In
Gas Line
Smoke Dampers
■k
411:4t PART FAIL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain ( I 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 OZ 7 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.