Permit CITY OF TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171
PERMIT # MEC97 -0123
DATE ISSUED: 05/08/97
EXPIRED PARCEL: 29111BD -00313
SITE ADDRESS...: 09910 SW PEMBROOK ST
SUBDIVISION • PEMBROOK HEIGHTS ZONING: R -3.5
BLOCK • LOT •3 JURISDICTION: TIG
CLASS OF WORK...:ADD FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE °SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:H2 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.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : JOB It 1369 // INSTL FURNPNCE DUCTS & VENTS & GAS PIPING
Owner-: FEES
JANINE WALDO type amount by date recpt
9910 SW PEMBROOK ST PRMT $ 25.00 TAT 05/08/97 97- 294331
TIGARD OR 97224 SPCT $ 1.25 TAT 05/08/97 97- 294331
Phone #:
Contract or:
MCCALL HEATING & COOLING CO
1650 NE LOMBARD
PORTLAND OR 97211
Phone #: 503-231-3311 $ 26.25 TOTAL
Reg #..: 001020
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 Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days.
Permittee Sig t'_re: ✓� _
Issu_ted By: —
Call for inspection — 639 -4175
City of,Tsgard MECHANICAL PERMIT Planck/Rec. #
13125 SW'Hall Blvd. APPLICATION Permit # ry)te, #11- Drl3
Tigard, OR 97223 EXPIRED
(503) 639 -4171 e�
- Name el Develo Descnption
Table 3A Mechanical Code QTY PRICE AMT
Address
Job 9 9/0 t,J 4',926. -e2 57 1) Permit Fee -0- -0- 10.00
Address •
ii CAL,,- 02 q--72.2_6/ 2) Supplemental Permit 3.00
?L,n,4or � et eusnsul Furnace to 100,000 BTU
. id 1) incl. ducts & vents I 6.00 fp.6X0
�f /4A2 `� /J ),2 /� Phone Furnace 100,000 BTU +
Owner 9 S Lc.},e, 7 brook S t 2) incl. ducts & vents 7.50
Moor Fumance
7? G/ e Q 97 2_2 L,/ 3) incl. vent 6.00
N a m e w n. of t e a m s * Suspended heater, wall heater
� 4) or floor mounted heater 6.00
* a � � r P Vent not incl. in
Occupant 5) appliance permit 3.00
CdylState Lo Repair of heating, refng.
6) cooling, absorption unit 6.00
Name Boiler or comp, heat pump, air cond.
///54- eq, 1/ ✓/7L�CL // 7) to 3 HP; absorp unit to 100K BTU 6.00
d ing address _ / Phone Boiler or comp, heat pump, air cond.
Contractor / ' sO ti Lo in b/� 8) 3-15 HP; absorp unit to 500K BTU 11.00
��s�ate Boiler or comp, heat pump, air cond.
R97 7 /Ld 0,2 .'J 2-// 9) 15-30 HP; absorp unit .5-1 mil BTU 15.00
State Rapstralsn No. Cdy &°• Tel No. Boiler or comp, heat pump, air cond.
/OZO3Q i/080 10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that I have read this application, that the Boiler or comp, heat pump, air cond.
information given is correct, that I am the owner or authorized 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with Air handling unit to
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50
•
Board, that the number given is correct. (If exempt from State Air handling unit
registration, please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected
15) to a single duct 3.00
Ventilation system not
; 5 / 9 7 16) included in appliance permit 4.50 e..,err� i-e'Gr-- tt Date Hood served by
17) mechanical exhaust 4.50
Describe work new 0 addition alteration 0 repair 0 Commercial or industnal
to be done residential 0 non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of 20) Gas piping one to four outlets I 2.00 2 . coo
building or property
21) More than 4 -per outlet (each) 2.00
Type of fuel - oil 0 natural gas( LPG 0 electric 0
NOTICE •
Minimum Fee $25.00 • SUBTOTAL 5 ,oc.
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE / .2.5
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL a(o.a s—
Special Conditions
Date issued by
M .OGIN\DS SMECMPMT
RECEIVED
MAY 0 8 1997
COMMUNITY DEVELOPMENT
05/16/2000 Activities for Case #: MEC97 -00123
12:27:03 PM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level _ By Updated Notes
MECA007 APPlication received 05/08/1997 05/08/1997 TAT 05/08/1997
MECA705 Gas Line Insp 05/08/1997 TAT 05/08/1997
MECA715 Mechanical lnsp 05/08/1997 TAT 05/08/1997
MECA725 Misc. Inspection 05/08/1997 TAT 05/08/1997
MECA799 Final Inspection • 05/08/1997 TAT 05/08/1997
MECA060 (F) Issue permit 05/08/1997 TAT PASS TAT 05/08/1997
MECA880 Expired by limitation 05/15/2000 HAP DONE No Hold AKJ 05/15/2000
• Page of •
. CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 • Business Line: 639 -4171
BUP
Date Requested p,, AM PM BLD
Location _19(Q P€4' Lh OL Suite MEC 9 - 7—O(y 2.3
Contact Person Ph PLM
Contractor MaAte Ph 2 31- 31 ( SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation n�pC ,� //� /� /� TV[S`�� -Q.Q ��)v FPS
Ftg Drain K.�C fit" a ILXJIJ 1. 9 elp171.1 SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
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
s--P
Rough In
Gas Line EXPIRED
Smoke Dampers
4110
SS PART FAIL
ELECTRICAL
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 D Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
/&" C
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639-41
0 C. 1(')-•
Date Requested: 6 (p I 1 (1 A.M. P.M. or MST:
Location: 13 ��FA BUP:
Tenant: Suite: Bldg: MEC: 5____C:24
Contractor: Phone: PLM:
Owner: EXPIRED Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Ro _ -Iri V Ceiling Water Line
Slab Framing Top Out %OM' 11° ' Rough -In UG Sprinkler
Foundation Insulation Sewer . . s► s ct_ // Reconnect Vault
Bsmt Damp Drywall Storm Q K 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 Approved Approved
'
Appr /Sdwlk Not Approved Not Approved i proved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
e.a 7 ---- - ,� me.. - z 4Z 4 f/,
Z t �i_ ' • ,01
63 9-- W ?/ •
,q5,e z 4 7377-7 7( V 7:-
O Call for re • - if O Reinspection fee of $ required bef•re next inspection O Unable to inspect
Inspector: / Date: If v Page of
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