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Permit •• J . .„ A CITY OF TIGARD MECHANICAL PERMIT I'� DEVELOPMENT SERVICES PERMIT #: MEC1999 -00157 ---"' �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/14/99 PARCEL: 25111 BD -00312 SITE ADDRESS: 09940 SW PEMBROOK ST SUBDIVISION: PEMBROOK HEIGHTS ZONING: R -3.5 BLOCK: LOT: 002 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: • FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: > GAS OUTLETS: 10000 cfm: Remarks: Install a new furnace. Owner: FEES GIBBONS, ROBERT J + NOREEN M Type By Date Amount Receipt 9940 SW PEMBROOK ST PRMT DST 4/14/99 $25.00 99- 314494 . TIGARD, OR 97223 5PCT DST 4/14/99 $1.25 99- 314494 • Total $26.25 Phone: Contractor: 5Pf. - '# LT1 H- f Airnllo' 9s as �L • 4& b Sr -- 0 `??9 - -3 REQUIRED INSPECTIONS Heating Unt Insp Phone: Ce 9.0- 54 q 3 Final Inspection Reg #: top G-7 8 • 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 i Ica i'o Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You ay obtain copies o thes7 or direct questions to OUNC by calling (503)246 -9189. j Iss e'By: L-f -- Permittee Signature: Afr, ` - - Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Plan Chec • •a CITY OF TIGARD Mechanical Permit Application Recd By.Ili , 41, 13125 SW HALL BLVD. Commercial and Residential . Recd • - / TIGARD, OR 97223 Date to P.E. (503) 639 -4171, x304 Date to DST ' r Print or Type Permit #Nlr / - a (5 / Incomplete or illegible applications will not be accepted Called 4 / - / 3 -F t a: y,7 Name of Development/Project Description Table 1A Mechanical Code Qty Price Amt Job Street Address Suite# A) Permit Fee 10.00 Address q9 .54 644.460iST 1) Furnace to 100,000 BTU including ducts & vents see footnote 1,2 / 6.00 Bldg# City /State D Zip 2) Furnace 100,000 BTU+ l f7- including ducts & vents see footnote 1,2 7.50 Name (or name of business)/ 3) Floor Furnace Owner R//ZIP/I-7- /' / M 6 including vent see footnote 1,2 6.00 Mailing Address l� 4) Suspended heater, wall heater g 9 L10 S �p ,{ or floor mounted heater see footnote 1,2 6.00 CO Q j_.drt -S r 5) Vent not included in appliance permit City /Sta ,, p U Zip ^� Phone / / it 'e � / 3.00 rr� � �O� '�O � Ch a ll t a pply: 'Boiler Heat Air Na (or name of business) For items 6 -10, see or Pump Cond Qty Price Amt S GC � footnotes 1,2 Comp OccU Occupant Mailing Address 6) 0K BTU unit to P 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 .l unit .5 -1 mil BTU 15.00 Contractor Name • 5 P e G / 42� 11,4716-- u) 30 -50 HP; absorb unit 1 -1.75 mil BTU 22.50 Prior to permit Mailing Address 10) >50HP; absorb unit `�'Sc issuance, a copy � K•S r / 5 S'T >1.75 mil BTU • 37.50 of all licenses city/state G ! Zip / Phone 11) Air handling unit to 10,000 CFM are required if / / q d ee 7 7 �s 1a 4.50 expired in COT oregof Cont. Cont . and Lie.# Ex . Date 1 2) Air handling unit 10,000 CFM+ database e 6..._< 7 r J// - 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 w tic to be done: 4.50 17) Domestic incinerators New I Repair 0 Replace with like kind: Yes /No O , 7.50 Residential Commercial 0 18) Commercial or industrial type incinerator 6 30.00 Additio nal information or description of work: 19) Repair units / � C-t -41- -- C44..- Ir" ffl /4 c'Pi 20) Wood stove 4.50 / 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" LPG 0 electric 0 4.50 22) Other units I hereby acknowledge that I have read this application, that the information 4.50 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) Signature of Owner /Agent J Date .50 �x d�'� w �S ` Minimum Permit Fee $25.00 SUBTOTAL gr Contact Person Name Phone ® 7 �� - 5 5% SUAE - h ��" PLAN REVIEW 25% OF SUBTOTAL 0 v Foonotes for commercial projects only: Required for ALL commercial permits only 1. Provide full schematic of existing and proposed gas line and pressure. TOTAL •-• 2. Provide drawings to scale showing existing and proposed mechanical • .4 iG9 units. *State Contractor Boiler Certification required **Residential A/C requires site plan showing placement of unit I:lmechperm.doc rev 02/4/99 . 5/10/99 Activities for Case #: MEC1999 -00157 2:58:42 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MECA007 Application received 4/13/99 GEO No Hold GEO 4/13/99 MECA008 Create Permit 4/13/99 GEO No Hold GEO 4/13/99 MECA725 Heating Unt Insp 4/13/99 4/13/99 No Hold GEO 4/13/99 MECA799 Final Inspection 4/13/99 4/13/99 4/23/99 KS PASS No Hold AKJ 4/25/99 MECA060 (F) Issue permit 4/14/99 DEB DONE No Hold DST 4/14/99 MECA705 Gas Line Insp 4/22/99 4/22/99 4/22/99 KS PASS No Hold AKJ 4/22/99 MECA800 Case Finaled 4/25/99 AKJ DONE No Hold AKJ 4/25/99 • • • • Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP p Date Requested y —7�3 - 7 AM PM BLD e Location / q qo P� f b/1DK_ Suite MEC 1 gq / -OD/S Contact Person K LQ Ph £p 2L Sta /3 PLM Contractor Ph SWR BUILDING Tenant/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 Framing Sv lO too [L1- C /4a ?c- 5 Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL (CHANT Post & Beam Rough In Gas Line A ke Dampers S)PART FAIL EL 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 Other Date V- 2 3 - 11 Ins Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. . CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 1 o b << BUP /� Date Requested 4/ - ZZ ' ! 9 AM� M BLD Location 9 L 0 ,,��, `eAl brl a S +. Suite MEC `� Contact Person t - 1 ►' t LQ Ph (,2 r S(L / 3 PLM Contractor Ph SWR BUILDING Tenant/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 A� Framing ( S . S` = t S, a Insulation Drywall Nailing hi /u vJrS C y 3 yyl Firewall Fire Sprinkler ��- Fire Alarm Susp'd Ceiling /' - ' V4L S Roof Misc: G' /�1 C, �D � /i�.i/3� iA,S 7 ,.. 10 A f'L<- Final PASS PART FAIL I STJ4 LL-A -77 t S (e cr•,. / 4 6, PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL di1CCHANIZ:AI Post & Beam Rough In Smoke Dampers ZFi ASS PART FAIL T RICAL 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 Hail, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other Date / Z2 T7 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.