Permit CITY OF TIGARD MECHANICAL
PERMIT
/ �
DEVELOPMENT SERVICES DATE 11/16 -0515
PARCEL: 2S103DA -04500
SITE ADDRESS...: 10600 SW PARK ST
SUBDIVISION • FANTASY HILL ZONING: R - 3.5
BLOCK • LOT :002 JURISDICTION: TIG
CLASS OF WORK..:OTR FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE °SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
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..: 1
GAS PRESSURE...: 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Add gas piping and gas insert.
Owner: FEES
TERRY WEESE type amount by date recpt
10600 SW PARK STREET PRMT $ 25.00 GEO 11/16/98 98- 310819
TIGARD OR 97223 SPCT $ 1.25 GEO 11/16/98 98- 310819
Phone #:
Contractor:
JACOBS HEATING & A/C
4474 SE MILWAUKIE AVE
26.25 TOTAL
PORTLAND OR 97202
Phone #: 503 -234 -7331
Reg #.. : 1441
REQUIRED INSPECTIONS
This per.it 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 per.it 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 -001 -0080. You lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
/ Issue By: /,/ Permittee Signature: 1LG
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TIGARD G 0 lole
chanical Permit Application Plan Chyck#
13i 25 SW HALL BLVD. commercial and Residential Date Recd
TIGARD, OR 97223 �`� \l 1 . " � �� Date to P.E.
(503) 639 -4171, x304 . ,,_, tv 5-.■!EA.0 ?'.. Date to DST
Print or Type Permit # Mr1 - +6515
Incomplete or illegible applications will not be accepted Called
Name of DevelopmenUProject Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 10.00
GG,, �,, n 1) Furnace to 100,000 BTU
Address
01oC0 + Par K including ducts & vents l 6.00 b .00
Bldg# City /State Zip -
2) Furnace 100,000 BTU+
J ■ Cpila De 91 including ducts & vents 7.50
Name (or name of business) 3) Floor Furnace
Owner ((lr %.1- ��. 1,Z2 _ including vent 6.00
Mailing Addres 4) Suspended heater, wall heater
t,,� or floor mounted heater 6.00
SC.,(nQ - ck.`J 5) Vent not included in appliance permit
City /State Zip Phone 3.00
(4,1 _ CHECK ALL Boiler Heat Air
- 19 5a
Name (or name of business) THAT APPLY: or Pump Cond Qty Pr ice And
Comp
6) <3HP;absorb unit to
Occupant Mailing Address 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
Contractor Name
unit .5 -1 mil BTU 15.00
1 ' 1 ,.� _ p 9) 30 -50 HP; absorb
J GC j f�'�f -a7C1 unit 1 -1.75 mil BTU 22.50
M ili
Prior to permit n A ^} ddr ss �v1, 10) >50HP; absorb unit
issuance, a copy 1 t • ■ ` >1.75 mil BTU 37.50
of all licenses • /Sta e ' (� ��pp Zip Phone 11) Air handling unit to 10,000 CFM
are required if V im- �� 1L3F
'- 4.50
expired in COT Oregon Co st. Q 12) g nt. Board Lic.# Exp. Date 12 Air handling unit 10,000 CFM+
database I1 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 work to be done: 4.50
17) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes 0 No 0 7.50
Residential Commercial 0 18) Commercial or industrial type incinerator •
30.00
Additional information or description of work: 19) Repair units
4.50
20) Wood stove
4.50
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gas. LPG 0 electric 0 22) Other units r
1 a -C'► r c.Q. l 4.50 1 130
I hereby acknowledge that I have read this application, that the information 23) Gas p+aing one to four o lets
given is correct, that I am the owner or authorized agent of I 2.00 ,?•00
the owner, hat plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
!� G.w►.12. ( rif 11 [ 111c .50
Signature of Owner /Agent V Date
�
( 'SUBTOTAL ` +1 -.00
(Y\ Q c . - �, ( Y1L- o / -�+� , vC�'F 13) 5% SURCHARGE � •c9�
Contact Person Name o Phone PLAN REVIEW 25% OF SUBTOTAL • ,
Required for ALL commercial permits only
TOTAL
- tOo.1.S
'Minimum permit fee is $25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit
I:\mechprm3.doc rev 06/23/98
%4Ol)i
7/25/99 Activities for Case #: MEC98- 00515
6:24:14 PM
L
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By • Disp. Level By Updated Notes
MECA007 Application received 11/13/98 GEO MAIL GEO 11/16/98
•
MECA008 Create Permit 11/16/98 GEO DONE GEO 11/16/98
MECA799 Final Inspection • 12/4/98 TLP PASS TLP 12/7/98
MECA705 Gas Line Insp 11/16/98 11/17/98 TLP PASS J *H 11/18/98 Tag 323142
MECA060 (F) Issue permit - 11/16/98 GEO PASS GEO 11/16/98
MECA800 Case Finaled 12/4/98 TLP PASS J *H 12/7/98
•
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Q BUP
. 3 /537 Date Requested / n /2-4- qCJ AM BLD
Location / (%2(X c V 14 / PAP---K- Si Suite MEC � r ` .. "G = s575
Contact Person M�AI /E Ph PLM /r'' 0 O3
Contractor 0A61S H - T6 ' Ph SWR
BUILDING Tenant/Owner 7--i,iS.. ELC �1
Retaining Wall ��JJ ELR
Footing Access:
Foundation /16 i / 7 9) .. 55/5 / 5 FPS
Ftg Drain � ,f7_ (� SGN
Crawl Drain Inspection Notes: /
Slab / S
Post & Beam hap
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Fire wall
Fire Sprinkler
Fire Alarm • / ` —
Susp'd Cell g
Roof
Misc:
Final
FAIL
c., PLUMBING___)
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
• Brains
Fi s :
CZ - - FAIL
. _ ► CAL j
Post Beam y'
h
Ro h In / 1 \ J .)
Smoke . -�Qi
Smoke Dampers i �17'''
'Final
FAIL
CTR
Service
Rough In
UG /Slab
F Looww �4 Vo a ltage
FT ,. final
S11'E PART FAIL
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 — (i rg / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.