Permit CITY OF T MECHANICAL
6 I DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE 10/09 -0457
PARCEL: 2S110CC -11900
SITE ADDRESS...: 15935 SW QUEEN VICTORIA PL
SUBDIVISION ° KING CITY NO. 3 ZONING:
BLOCK • LOT :032 JURISDICTION: KIN
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE °SFA UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:RI. 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.: 0
FURN > =100K BTU: 0 ) 10000 cfm: 0
Remarks: Furnace
Owner: FEES
FUMICO WHEELOCK type amount by date recpt
15935 SW QUEEN VICTORIA PL PRMT $ 25.00 B 10/09/98 KING CITY
KING CITY OR 97224 5PCT $ 1.25 B 10/09/98 KING CITY
Phone #:
Contractor:
COMFORT ZONE HEATING & COOLING
3204 SE KELLY ST
86.25 TOTAL
PORTLAND OR 97202
Phone #: 296 -4655
Reg #..: 46238
REQUIRED INSPECTIONS
This permit, is issued subject to the regulations contained in the Mechanical 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 952-001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
1
Issue B y: ► �— P e r m i t t e e Signature: ��^ I lCr O} —(Vta
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
__ -. _�.00T -09 — ' 98 FR I 15:06 ID: FAX N0: U077 P02
- Plan Check !f •
CITY OF TIGARD Mechanical Permit Application Redd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
Date to DST i d - 8 -
(503) 639 -4171, x304 Permit # �'
Print or Type Called
Incomplete or illegible applications will not be accepted
•
Name Of DeveloprnenUProled \ Description
A \ a r � Table 1A Mechanical Code fat I Price Amt
V A) Permit Fee iY , "4a'k%;i: , . , " ': ;,vhS 10.00
Job street address Suitop
) . 5 3 f'' sw g 0 e e.✓1 1) Furnace to 100,000 BTU
Address including ducts &vents 6.00
gidga city/Siele Zip 2) Furnace 100,000 BTU+ -
f K t pry, e including ducts & vents 7.50
Name (or name of busin / / 3) Floe( Furnace
/� �� /_ including vent 6.00
Owner i� .1.Yt 1 40 1/f" '�� 6. 4 4) Suspended Heater, wall heater
Mailing Adores or floor mounted heater 6.00 .
• S(7- sites. 5) Vent not included In appliance permit
City /Stale Zip I Phone 3,00 ,
CHECK ALL 'Boiler Heat Air
THAT APPLY: or Pump Cond Qty Price Arnt
name (or norm of bwoinesa) _ Comp -*
5 c o_ ,41,..1.. 6) <3HP;absorb unit to •
Occupant Mailing Address 100K BTU 6.00 •
7) 3 -15 HP;absorb unit
clty/Stale • Zip — P hone 100k to 500k BTU 11.00 -
'
8) 15 -30 HP; absorb •
unit .5 -1 mil BTU 15.00
Contractor Nae 9) 30 -50 HP; absorb _ 1
r �� p
� m iPJ e'n. �� �� 17 -- �T f 1 unit 1 -1.75 mil BTU 22,50
Prior to permit Meiling Address 10) >5011P; absorb unit
issuance, a copy 52.0 cf' 1C k q
>1.75 mil BTU , 37.50
of all licenses CityiSlate Zip Phone 11) Air handling unit to 10,000 CFM
are required if
if: / 2®L- Z36 4.50
t r J w
expired In COT ft Corp, r IC.a . Exp. Dale • 12) Air handling unit 10,000 CFM+
database q _ 7.50
Architect Name 13) Non - portable evaporate cooler
4.50
14) Vent fan connected to a single duct
or Mailing Address 3.00
-
15) Ventilation system not,included in
C ity /State Zip Phone appliance permit 4.50
Engineer 16) Hood served by mechanical exhaust
4.50
Describe work to be done: 17) Domestic incinerators
7.50 _
New 0 e air 0 Replace with hike kind: YesY No 0 "i 6) Commercial or industrial type incinerator
Residential Commercial 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 O natural gas)' 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
given is correct, that I am the owner or authorized agent of More than 4 -per outlet (each)
the owner, that plans submitted are in compliance with Oregon State laws. 24) .50
-
/ i �{ CC
Si, • -tu� • Cr! • !ant Date
Mini
� /D �� mum Permit Fee $25,00 SUBTOTAL .7.`‘ 1 ; ` 2S
�' 5% SURCHARGE ,, /, r ` �r • PLAN REVIEW 25% OF SUBTOTAL �' f -• % ` � �'
Contact Person Name -
R equired for ALL commercial • rrnits and ✓,
/`3 " �`� sod - 7- C -' �Gl TOTAL `� „ 2-S
*State Boiler Certification required
"'Residential NC requires site plan showing placement of unit
I:\rnechperm.doc rev 07/20/98
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested I0 AM PM?-i• BLD
Location / J 3 L6ge+✓1. j Suite } n � —0 O '57
Contact Person �LA �Lb LJ\ 6 LO CAL Ph 42* `7 -- d U 3.7/
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation -a.Ce FPS
Ftg Drain
Crawl Drain NOT REQUESTED SGN
Slab FOUND DURING RESEARCH SIT
Post & Beam
Ext Sheath /Shear NO INSPECTION(s) IN FILE
Int Sheath/Shear R 1
Framing
Insulation
Drywall Nailing ,n (� ,( �/ d
Firewall IV 6_C C `' AGCA b — O0 Lc / ' VI■ 1 I1 G
1
Fire Sprinkler '\ t
Fire Alarm ) \ � L 0 001 f )- v �`r,�. A(
Susp'd Ceiling
Roof
Misc:
Final
PASS c-R.417 FAIL ' l � 564 -L5
MBING
Post & Beam ` - �, _'
Under Slab � S v v •/(--- •
Top Out
Water Service
Sanitary Sewer
Drains
ASS PART FAIL
ANIt✓
Post & Beam
Rough In
Gas Line
S m ��e Dampers
�1iia _ PART FAIL
RICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm Ili
Final
PASS PART FAIL
SITE �\
Backfill /Grading
Sanitary Sewer V: \
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 1 D _
Other
Date l / I nspector A. (5 l Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.