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Permit CITY OF TIGARD MECHANICAL DEVELOPMENT SERVICES PERMIT I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # MEC97 -0342 L DATE ISSUED: 09/29/97 PARCEL: 2S1O2AA -00602 SITE ADDRESS...: 11960 SW PACIFIC HWY SUBDIVISION • TIGARD HIGHWAY TRACTS ZONING: CBD BLOCK • LOT :010 JURISDICTION: TIG CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0 TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 2 OCCUPANCY GRP..:M VENTS W/0 APPL: 0 VENT SYSTEMS: 0 STORIES • 1 BOILERS /COMPRESSORS HOODS • 0 FUEL TYPES 0 -3 HP • 1 DOMES. INCIN: 0 :NG 3 -15 HP : 3 COMML. INCIN: 0 MAX INPUT: 0 BTU 15 -30 HP • 0 REPAIR UNITS: 0 FIRE DAMPERS ?..: N 30 -50 HP • 0 WOODSTOVES..: 1 GAS PRESSURE...: L 50+ HP - 0 CLO DRYERS..: 0 NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 1 FURN < 1O0K BTU: 1 <= 10000 cfm: 4 GAS OUTLETS.: 8 FURN > =1O0K BTU: 3 > 10000 cfm: 0 Remarks : Mechanical portion of TI /complete re.odel, new furnaces, air conditioners, ducting & pellet stoves. Owner: FEES AMAN ENTERPRISES INC type amount by date recpt PO BOX 230849 PRMT $ 150.50 DRA 09/29/97 97- 299625 TIGARD OR 97281 PLCK $ 37.62 DRA 09/29/97 97- 299625 5PCT $ 7.53 DRA 09/29/97 97- 299625 Phone #: Contractor: AMAH ENTERPRISES INC PO BOX 230849 $ 195.65 TOTAL TIGARD OR 97281 Phone #: 968 -7596 Reg #.. : 101803 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 Cooling Unt Insp approved plans. This peruit will expire if work is not started Misc. Inspection within 180 days of issuance, or if work is suspended for lore 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 -00110 through OAR 952 - 00180. You lay obtain copies of these rules or direct questions to OUNC by calling (503)246 -9187. 1 Issue By: 0 .L 'c Permittee Signatur- ++++++++++++++++++++++++++++++++++++++++++++++++ + + + +++ + + ++ + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 6:00 p.m. for inspections needed the next business day Plan Check 0 ' • 0 CITY OF TIGARD Mechanical Permit Applicatio ,i / Recd By= C _: 13125 SW HALL BLVD. �\ Commercial and Residential � Da Rec %597 TIGARD, OR 97223 � � b ' Date to P.E. / (503) 639 -4171, x304 �y� Date to DST �► Print or Type &V Permit # McGq 7-0 34 Called Incomplete or illegible applications will not be accepted Name of Development/Projaa Description AMAI4 �OL. Table 1A Mechanical Code aTY PRICE AMT Job street Address - su A) Permit Fee -0- -0- 10.00 Address 11160 t'tG kv oik .-4,440 1040 Bldg# , , fit y g i r rio �2, 1.) Furnace to 100,000 BTU y� � 6.00 '� Gl� Z3 including ducts ( ` * may ) s & vents I �/� ;oho (0 0° Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50 Owner /al . ' 2t41 I 06. including ducts & vents 3 aa.5 Mailing Address 3.) Floor Furnace 6.00 Pc,. IJps. 1.30g7e4"9 including vent 11 City/State Zip Phone Suspended heater, wall heater 6.00 4.) 4 1 CO' a( 9 (.F, -70,1 or floor mounted heater Name (or name of business) . 5.) Vent not included in appliance permit 3.00 i4 WUM144415 , fide, folizet Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00 P O , 13tox '23O 40) (0.00 City/State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00 . - �� -R('P1' 0 02. 1/%151 9(.8" 759{. 3-15 HP; absorb unit to 500K BTU** 0) - Contractor Nam 8.) Boiler or comp, heat pump, air cond. 15.00 (Prior to APAAI) eth1010/44c34 1 oei, 15-30 HP; absorb unit5-1 mil BTU" issuance Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50 applicant Q O, r 3 G L 1 30-50 HP; absorb unit 1- 1.75mil BTU" must provide all City/State zip 1 P 10.) Boiler or comp, heat pump, air - nd. 37.50 contractor 11 W c n g I LQ -1551. > 50 HP; absorb unit 1.75 mil' BTU"' license Oregon Corwrcont Board Lic./f Exp. Date - 11.) Air handling uttit fo 10900 bRM' 4.50 information if _ 1O16 03 it 11a7�� , � ig . oO • expired O r COT COT Business Tax a Metro a Exp. Date , / 12.) Air handling unit 10,000 CFM 7.50 database). 11- t t1('i.1 IftelOIP.r Architect Na/ne 13.) Non portable evaporate cooler 4.50 or Mailing Address 14.) Vent fan connected to a single dud 2---. 3.00 /^ 0(/ UI' Engineer City /State Zip Phone 15.) Ventilation system not included in 4.50 appliance permit Describe work New 0 Addition 0 Alteration K Repair 0 16.) Hood served by mechanical exhaust 4.50 to be done Residential 0 Non - residential 0 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 20.) Wood stove / 4.50 �, Proposed use of ` 21.) Clothes dryer, etc. 4.50 building or property r�11. SJ h STGV6e7 S 34..00 22.) Other units T w �, ✓ ( 4.50 4. Type of fuel - oil 0 natural gaslilk LPG 0 electric 0 23.) Gas piping one to four outlets 1 2.00 /C,Q I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) 47 .50 j 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. tg f % - - r /Agent Date 'SUBTOTAL is . 0 - %t � / I ( e tiZ 9't 5% SURCHARGE r2 Contact P ' ` Name Phone PLAN REVIEW 25% OF SUBTOTAL 62, As T" 0610FAAO 4 1 1/ $ ..-15 c. TOTAL _3 ?---=---- i:ldsechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge l 1 5''G tim "Residential NC requires site plan showing placement of unit. OVER-THE-COUNTER (OTC) PERMIT COMMERCIAL MECHANICAL PERMIT CHECK LIST Description of Project: 601A -*. ill'ACI3L3\-' t-hgeV4 loVrio AtS . 6 6i t— 60.0710 -o / 0 OR 12 . 1 (411-kr - 4- A&I--.72 Class of Work: All Floor Furnace: 4 : 7 Evap Coolers: < Type of Use: COM Unit Heaters: 4C7 Vent Fans: 1. Occupancy Grp: M 1 Vents w/o Appl: Vent Systems: Stories: i Boilers/Comprsrs: Hoods: 0 Fuel Types - 14er . 0 - 3 HP. I Repair Units: / / / / 3 - 15 HP. S Wood Stoves: I Max Input: 1&42g,Btu:;414Air Handling Units Clo Dryer: Fire Dampers: b <= 10000 cfm: 4 0th Units: I Gas Pressure: H / M /0, > 10000 cfm: Gas Outlets: 0 7 L/ taAPAAAAAA*46,46■ 4 t..1 Furn < 100k Btu: I Furn >=100k Btu: 3 • NOTES: itr 2 ., ii ,4 ir 2 0,-, /,I t t I, i LI A 7f r p go 1,1 I r , . ..e v .e _ — .'-r l 1 0 )/A t :iiii ................................................. 111:11:::::801::::112fgkMPICI:::::iiiiiiiiiiii:::::::::::::::::::::::::!::::::::1::ii::::::::1 $ ow E° Permit Fee Gas Line Inspection $ Plan Review — Mechanical Inspection $ 2 V 5% State Surcharge > Cooling Unit Inspection $ Additional Permit Fee Shaft Inspection $ Additional Plan Review Fee Hood Inspection $ Inspection Fee Fire Suppr Inspection S Miscellaneous Fee Duct Inspection / 2 et re de Fire Alarm Inspection Fire Damper Inspection REMARKS: 4 6/ f 1.19 x Miscellaneous Inspection k/ del) j imI9 V! J No el i 7 i'N .1,' Fire Alarm Inspection cOy* Oe 1"Ferol )71 m 1) d am . — Final Inspection "1 (19 ay\ 4-4 j ) f913';i:ciffigg:4PE: T*giPf::pg..Pf#:iQ14:::tqCiIA:#*it?if • 0:000::::WOOKipprotto**cootoot*(146*:4::*4;::*wiliiioiow*titi::40446.::Woi:k6400::::::::::::::::::m:iio:::iiig::::::::i:ii:Iiiiiiiiiii:i1::::::: tso.::#.::0Aoiookoottoiit o.4.(#it*oirtj6:ei:::ftk.#.:00#14:::t00ii)fii$(.0*:*i:*i*#6.'iiWtt*tj:SE:0tRroktgk.g.4:::::: Ft*ii4ii40.: pt:::giit i:kovrcntr.doc (dst) 8/97 • . 1 HEAT -N-GLO FIREPLACE PRODUCTS, INC. • I. APPROVAL LISTINGS AND CODES • A. APPLIANCE CERTIFICATION These models have been tested to the certification standards and listed by the applicable laboratories as shown in the table: LABORATORY ME CERTIFICATION STANDARD 8000GDVFL A.G.AJCGA DIRECT VENT DECORATIVE ANSI Z21:50/IR#41 6000GDVFL AGAJCGA DIRECT VENT DECORATIVE • ANSI Z21.50/1R#41 6000XLS A.GAJCGA .. DIRECT VENTMALL FURNACE ANSI Z21.44/IR #41 /CAN1 -2.18 B. INSTALLATION CODES III. PRE - INSTALLATION Consult your local building ODde agency, prior to ice- PREPARATION lion, to ensure compliance with local per- mits and inspections. This direct vent gas fireplace and its components are tested Installation must conform to local codes. In the absence and safe when installed in accordance with this Installa- of local codes, installation must conform with the current lion Manual. Report to your dealer any parts damaged in National Fuel Gas CodeANSI Z=3.1 (in the United States) shipment, specifically check glass condition. Do not install or with the current installation code CAN/CGA - 6149 (m unit with damaged, incomplete, or substitute parts. The Canada). vent system components and trim doors are shipped in The apptienoewthen installed must be electrically grounded separate packages. The gas logs are factory installed (Model 13000GDVFL 8 6000GDVFL) and are packaged in accordance with local codes; in absence of local codes, separately and must be field installed (Model 6000XLS). with the current National Electric Code ANSIMFPA No. 70 Read all instructions before (m the United States) or with the current CSA C22.1 Ca- follow these ir>strucdons carefully dudng installation nadlon Electric code (fn Canada). to insure maximwn benefit and safety. Failure to fol- These models may be installed in a bedroom or bed -sit low them will void your warranty and may present a ting room in the U.S. A. and Canada. life hazanL The b � o Inc II. INTRODUCTION . dis- claims any responsibility for the following actions: These modals are direct vent gas appliances and are de- • Installation of any damaged fireplace or vent system signed to operate with all combustion air being component from the outside of the building and all exhaust gases ex • Modification of pelted to the outside of the buldtrhg. The Information con- the fireplace or direct vent system tafrhed in this manual petfelos to all models • and gas con- • In ion o than as instructed by Heat -N.Gio Fireplace Products. Inc Ind systems unless otherwise noted. 1 y • Improper positioning of the gas logs or the glass door. • Installation and/or use of any component part not manufactured or approved by Heat-N-Gb Fireplace �' : �•' ' ��" '� ' � ` Products, Inc., notwithstanding any independent test- Two types of gas control systems are used in these mod- Mg laboratory or other ply approval of such compo- els. (Model 6000XLS has standing pilot only). nerd Part or acc'ssory. • STANDING PILOT IGNITION SYSTEM: Includes nil, ANY SUCHACTION MAY POSSIBLY CAUSEA FIRE HAZ Gvolt control valve, steramg pilot. themropiltr/tfnemm- ARD• couple flame sensor, and pine° igniter. 110 -120 VAC In Alarming the installation for the fireplace. it Is necessary must NEVER be connected to a control valve in a to determine where the unit is to be installed the vent llivoft system • D SPARK IGNtT10N DSI SY37EM: Includes tern oonfguration to be used. framing and finishing details, in a DM system. 24V control valve. electronic module, trartsforhrher. • and �� optional soot (fan, wall switch or re- spark sensor: 110 -120 VAC MUST be cal are desired b Gas piping and s loc e- wired to the fireplace junction book cal wiring should also be planned. Figure 1 shows loca- tion of features on the appliance and fireplace dknensions. Optional Acc s available we Bated in that section of this manual. MODELS: 8066GDVtL, 60000GDYFZ, 6000las Page -6- • Page No. 1 CASE HISTORY FOR CASE NO.: MEC97 -0342 AMAN ENTERPRISES INC 11960 SW PACIFIC HWY 02/17/99 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd Code Sent Done Done Date By ---- - -- -- -- - - -- - -- MECC007 Application received / /• / / 09/15/97 PASS JDA 09/15/97 DST MECC008 Permit created / / / / 09/15/97 PASS JDA 09/15/97 DST MECCOII Routed to Plans Examiner / / / / 09/15/97 PASS JDA 09/15/97 DST MECC014 Plan checked /Approved by P.E. / / / / 09/29/97 APPR JHF 09/29/97 DRA MECC015 Reviewed Plans Routed to DSTS / / / / 09/29/97 PASS JHF 09/29/97 DRA MECC090 (F) Issue permit / / / / 09/29/97 PASS DRA 09/29/97 DRA MECC705 Gas Line Insp 09/29/97 / / 10/10/97 No pressure on gas line. FAIL TLP 10/11/97 J *H MECC705 Gas Line Insp / / / / 10/28/97 PASS TLP 10/28/97 J *H MECC706 Mechanical Insp 09/29/97 / / 10/10/97 FAIL TLP 10/11/97 J *H MECC730 Cooling Unt Insp 09/29/97 / / 02/10/98 PASS TLP 02/10/98 J *H MECC735 Duct Inspection / / / / 12/11/97 This inspection for environmental PASS TLP 12/12/97 J *H heating only: All duct work in ceiling okay. "Display" interior fireplaces not completed at this time. MECC750 Misc. Inspection 09/29/97 / / 10/28/97 Maintain min. 1 -inch clearance around PASS TLP 10/28/97 J *H all furnace gas vents - check at ceiling cover inspection. MECC799 Final Inspection / / / / 01/07/98 1. Floor protection required for Earth FAIL GS 01/08/98 J *H Stove Model 2806HT. 2. Complete condensate pipeing. 3. Ceiling cover for HVAC okay. MECC799 Final Inspection / / / / 02/10/98 PASS TLP 02/10/98 J *H MECC800 Case Finaled / / / / 02/10/98 PASS TLP 02/10/98 J *H