Permit . ._.
CITY OF T MECHANICAL
:711,,W4, �,; n ; ; � DEVELOPMENT SERVICES PERMIT
,1Ili� PERM I T # : MEC97 -0850 0
13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 DATE ISSUED: 12/05/97
PARCEL: 2S102CB -00303
SITE ADDRESS...: 13165 SW PACIFIC HWY
SUBDIVISION • NORTH TIGARDVILLE ADDITION ZONING: C —G
BLOCK LOT •033 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:P3 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 < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Moving gas pipe line five feet.
Owner: FEES
POORMAN, MARTHA & JOHN type amount by date recpt
13165 SW PACIFIC HWY PRMT $ 25.00 B 12/04/97 97- 301443
TIGARD OR 97223 SPCT $ 1.25 B 12/04/97 97- 301443
Phone #:
Contract or:
MODERN PLUMBING CO
D & D ACQUISITIONS INC
11120 SW INDUSTRIAL WAY $ 26.25 TOTAL
TUALATIN OR 97062
Phone #: 691 -6.166
Reg #..: 000879
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 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- 001 -0010 through OAR 952 -01 -0880. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
I
1r1 �/, s -- p /, / ,�,Q�
Issue B y: fill4 Y/s"� P e r m i t t e e Signature: or Iaek _ timke l
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 - 4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ ++
Plan Che # , ' 1 - 0i56
- t% D
CITY OF TIGARD Mechanical Permit Application Recd By : ' a ....- 1 !. 0 a -
131.25 Sw HALL BLVD. Commercial and Residential Date Recd -
TIGARD, OR 97223 • Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type • Permit #
Called
Incomplete or illegible applications will not be accepted
Nam of Development/Project Description
U A.A K 1 Y1 ("- Table to Mechanical Code Orr • PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address 1 31 to S 5 co IAA t±. i
u
Bldga - City/State Zip B) Supplemental Permit 100
Ttela...4 l -
Name (or name of business) 1.) Furnace to 100,000 BTU 6.00
Owner '5 1 YVl lit VDir k Cm ?AS 1 • incl. ducts & vents
•
Mailing Address 2.) Furnace 100.000 BTU + 7.50
incl. ducts & vents
City/State Zip I Phone 3.) Floor Furnace 6.00
incl. vent
Name (or name of business) 4.) Suspended heater, wall heater 6.00
or floor mounted heater
Occupant Mailing Address 5.) Vent not incl. in 3.00
appliance permit -
City/State Zip I Phone 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP: absorp unit to 100K BTU
Name 7.) Boiler or comp, heat pump, air cond. 11.00
M019 fAe..&.) ? LO P1i 1 ri (a 3-15 HP; absorp unit to 500K BTU
Contractor Mailing Address 8.) Boiler or comp, heat pump, air cond. 15.00
I I 1 Zo St.e.) -L1^ S4yt'a. 1. UDe i 15-30 HP; absorp unit .5-1 mil BTU
(Prior to ' City/State //� L Zip Phone . I. f 9.) Boiler or comp, heat pump, air cond. 22.50
issuance a copy TV L✓tLl�l.". tile- �7ptb 1- 'col (p 6 30-50 HP: absorp unit 1 -1.75 mil BTU
of all licenses are Oregon c C hB and Licit Exp. ate 10.) Boiler or comp, heat pump, air cond. 37.50
required if (' 0 0'1 1 U( ii/ 19 ( f • > 50 HP; absorp unit 1.75 mil BTU
expired in C.O.T c u . ess Tax a Exp. ate 11.) Air handling unit to 4.50 •
data base) 01 ////f a 10,000 CFM
Architect N e 12.) Air handling unit 7.50
10.000 CTM +
or Mailing Address 13.) Non portable 4.50
evaporate cooler
Engineer City/State Zip - Phone - 14.) Vent fan connected 3.00
to a single duct
Describe work New 0 Addition 0 Alteration ' Repair 0 15.) Ventilation system not 4.50
to be done Residential 0 Non - residential O included in appliance permit
Additional De cription of work ,, 16.) Hood served by mechanical exhaust 4.50
✓V1 by P c\&s (.5mA-it se ci-t o,
Q 1/ PX S kNG.y 4 I y 7rb ' , 17) Domestic incinerators 7.50
Existing use of ^ ^ ` � � � ` 4 18.) Commercial or industrialtype 30.00
building or property IJ ) incinerator
19.) Repair units 4.50
Proposed use of ,n In I „ 20) Woodstove 4.50
building or property 1 ) 1 �iC V ` ,
21) Clothes dryer, etc. 4.50
Type of fuel - oil 0 natural gas CK( LPG 0 electric 0 22) Other units �/ 4.50
I hereby acknowledge that I have read this application, that the 23) Gas piping one to four outlets 2.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State �J 24) More than 4 -per outlet (each) .50
Sign a ure o f er efit" Date QTY.SUBTOTAL
14 6,7` l V` U�� J�--( Iff 1 i J // / 'SUBTOTAL a S 67-if)
Pers n Nafne Phone 5% SURCHARGE
).
PLAN REVIEW 25% OF SUBTOTAL
TOTAL d CO c)C
i :ldstrnechpmt.doc (rev 7/96) 'Minimum permit fee is S25 + 5% surcharge
- (i --qr 7S-
Page No. 1 CASE HISTORY FOR CASE NO.: MEC97 -0850
MODERN PLUMBING
13165 SW PACIFIC HWY
04/09/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Dome Done Date By
- --- --- -- - - - --- - --
MECC007 Application received / / / / 12/04/97 RECD B 12/04/97 BON
MECC008 Permit created / / / / 12/04/97 DONE B 12/04/97 BON
MECC090 (F) Issue permit / / / / 12/05/97 PASS B 12/05/97 BON
MECC799 Final Inspection / / / / 01/09/98 PASS GS 01/11/98 J*H
MECC800 Case Finaled / / / / 01/09/98 PASS GS 01/11/98 J *H
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 9 / _ A.M. P.M. MST:
Location: �/ t - l . BUP:
Tenant:(/) � A ./71 / Suite: Bldg: MEC: 9 7 `Oef�
/
Contractor: V O Phone: 3 3 ° 07 q Bl / PLM: 77— ac57
Owner: Phone: ELC:
0.PI L2. -M D� ELR:
SIT:
BUILDING BLDG (con't) . „--•"" --- UMBING MECHANICAL . ELECTRICAL SITE
Site Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFUSlab 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 Spk1r /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not A oved Not Approved Not Approved Not Approved
FINAL INAL a/l FINAL FINAL FINAL
,
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O Call for re' 7 tion O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: .-.1 Date: 1/ �� � Page of /