Permit CITY OF TIGARD MECHANICAL
� k DEVELOPMENT SERVICES PERMIT
13125 SW 639-4171 CES PERMIT # MEC98 -0399
DATE ISSUED: 09/24/98
PARCEL: 2511OCD -00114
SITE ADDRESS...: 11755 SW QUEEN ELIZABETH ST
SUBDIVISION • KING CITY NO. 2 ZONING:
BLOCK • LOT JURISDICTION: KIN
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE °COM UNIT HEATERS..: 0 VENT FANS...: 2
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 1 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 2 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 < 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =1O0K BTU: 2 > 10000 cfm: 0
Remarks : Add mechanical for a new Dental Lab.
Owner: FEES
MOOKI DENTAL LAB type amount by date recpt
11870 SW KING JAMES PLACE PRMT $ 47.00 DEB 09/24/98 98- 309476
KING CITY OR 97224 PLCK $ 11.25 DEB 09/24/98 98- 309476
SPCT $ 2.25 DEB 09/24/98 98- 309476
Phone #:
Contract or:
AIR COMFORT INC
6800 NE 59TH PLACE
$ 60.50 TOTAL
PORTLAND OR 97182
Phone #: 287 -2888
Reg #..: 000588
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 Heating Unt Insp
approved plans. This permit will expire if work is not started Cooling Unt Insp
within 180 days of issuance, or if work is suspended for more Duct Inspect ion
than 180 days. ATTENTION: Oregon law requires you to follow rules Misc. I n s pe ct i o n
adopted by the Oregon Utility Notification Center. Those rules are Final Inspection
set forth in OAR 952- 001-0010 through OAR 952-001-0880. You may F,..i r.o=tz,;-a.r,
obtain copies of these rules or direct questions to OIJNC by calling
(503)246 -9187.
Issue B L /Y�'L,�Q c � Perm S ignatu re: A d ."
T �
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY.OF TIGARD Mechanical Permit Application Plan Check #O 3 / C° _
PP Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd y -iy-y$--
TIGARD, OR 97223 Date to P.E. ''4--
(503) 639 -4171, x304 Date to DST ' • d 'r, 1'
401( ,�� Print or Type y,� -� /oq Permit# (/ J ;t 0 3WJ
Incomplete or illegible applications w not be accepted Called i� 98 s 5 3
Name of Development/Pro ect Description J
M OO is / e Table 1A Mechanical Code Qty Price Job StreetAddre , A) Permit Fee y' ':, 10.00
Address /✓�7,5v � J 1) Furnace to 100,000 BT
.� including duds 8 vents 6.00 `/
Bldg# eC`rty/ r ate Q Zip 2) Furnace 100,000 BTU+
� including ducts & vents Z, 7.50 `�j
Name (or name of business) 3) Floor Furnace
including vent 6.00
Owner
Mailing Addre n i " " i4/4/) 4) Suspended heater, wall heater
/ 2 :. 5 Vent floor mounted heater 6.00
fie, Vent not included in appliance permit
ag� {�tte Zip Phone
ien 3.00
Ot � /� CHECK ALL 'Boiler Heat Air • Na me or name of business) THAT APPLY: or Pump Cond Qty Price Amt
/ ) / /-J Comp Comp ..
M ai in Address .// 6) <3HP;absorb unit to l �
Occupant g 14 P�� 7) 3-15 BTU 6.00 /
7,�,Jr s , 7) 3 -15 HP;absorb unit
City /State Zip Phone 100k to 500k BTU 11.00
• OG %7 u) unit . 5-1 mi l absorb
unit .5 -1 mil BTU 15.00
Contractor Na 9) 30-50 HP; absorb
#,M, t 7 r7C unit 1 -1.75 mil BTU 22.50
Prior to permit ailing Ad ress 10) >50HP; absorb unit
issuance, a copy 6 t�� r,�� I Q, >1.75 mil BTU 37.50
of all licenses /St Zip Phone
� 11) Air handling unit to 10,000 CFM
are required if /p / _ � 9 y ' j, , 7 .7�r 4.50
expired in COT Oregon Const. Cont. Boa c.# Exp. Date 12) Air handling unit 10,000 CFM+
database ur",P <- I ) s -oC) 7.50
Architect Name 13) Non - portable evaporate cooler
/A �Q 1 ./ - 4.50
or Mailing9�33r v S' 444 / 14) Vent fan connected to a single duct / a0
c °° i i _ /i 3.00
( / Lit/ . < 15) Ventilation system not included in
Engineer C / °1d1 /O `, ,� Zip <3IJ,� appliance permit 4.50
drl Q , I 21 -3O'L 16) Hood served by mechanical exhaust
Describe work to be done: ` ' 4.50
17) Domestic incinerators
New V Repair 0 Replace with like kind: Yes 0 No 0 7.50
Residential 0 Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
4.50
• 20) Wood stove
AI c /. 4.50
21) Clothes dryer, etc.
• 4.50
Type of fuel: oil 0 natural gas 'LPG 0 electric 0 22) Other units
4.50
I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets ao
given is correct, that I am the owner or authorized agent of 1 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Signature of Owner /Agent Date
������ ���� Minimum Permit Fee $25.00 SUBTOTAL
mow
lwu 9/# �t�
5% SURCHARGE
Contact Person Name Phone a PLAN REVIEW 25% OF SUBTOTAL
AI ' A' % ^I � ils p Required for ALL commercial permits only on
, V v / 015 EA/ 8 Q TOTAL
*State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I:knechperm.doc rev 07/20/98
•
KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224.2693
® Phone: (503) 639 -4082 • FAX (503) 639-3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City' staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: 1 14/ w PtfaJ c2Z
located at: /5755 Jc) & M
16062,-
King City Representative
I: DSTS\KCINST.000
Page No. 1 • CASE HISTORY FOR CASE NO.: MEC98 -0399
MOOKI DENTAL LAB •
11755 SW QUEEN ELIZABETH ST •
03/02/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
-- -- - -- -- - - - - -- - --
MECC007 Application received / / / / 09/14/98' RECD GEO 09/15/98 GEO
MECC008 Permit created / / / / 09/15/98 DONE GEO 09/15/98 GEO
MECCOII Routed to Plans Examiner / / / / 09/15/98 SENT GEO 09/15/98 GEO
MECC012 Plan Review Ltr. to Ofc. Svcs. 09/16/98 / / 09/16/98 PEND RDP 09/16/98 RDP
MECC014 Plan checked /Approved by P.E. / / / / 09/23/98 APPR RDP 09/23/98 RDP
MECC015 Reviewed Plans Routed to DSTS / / / / 09/23/98 APPR RDP 09/23/98 RDP
MECC016 DST Post- Review Completed / / / / 09/23/98 PASS JSD 09/23/98 JSD
MECCO50 (F) Ready to issue / / / / 09/23/98 PASS JSD 09/23/98 JSD
MECC090 (F) Issue permit / / / / 09/24/98 DONE DEB 09/24/98 DST
MECC705 Gas Line dnsp 09/23/98 / / 11/03/98 Gas tag # 340543 PASS RC 02/05/99 ROC
MECC705 Gas Line Insp / / / / 02/11/99 INTERAL GAS LINE ADDED AT WORK STATIONS PASS RC 02/12/99 ROC
AND ROOMS AFTER GAS TEST,LINE NEEDS
TESTING BEFORE CONNECTING TO MAIN GAS
LINE
GAS LINE AT WORK STATIONS APP.
MECC706 Mechanical Insp 09/23/98 / / 10/27/98 Mechanical not ready - resubmit plans FAIL RC 10/27/98 J *H
for revisions (show mechanical room &
• fireplace)
1. Mechanical not ready.
2. No pressure on line.
3. Unsure of gas pressure.
• 4. Mechanical permit does not include
fireplace, please revise.
MECC706 Mechanical Insp / / / / 10/30/98 $15.00 reinspection fee-assessed for FAIL RC 11/02/98 J *H
corrections not completed:
1. Bath fans need to be connected at
rough in - 2nd notice.
2. Need combustion air ducts in furnace
rooms at roughin.
3. Instructions for fireplace not at
site.
•
•
MECC706 Mechanical Insp 11/04/98 / / 11/03/98 1. Insufficient combustion air for FAIL RC 11/04/98 J *H'
mechanical room with furnace and water
heater. What is input rating of water
heater (100 square inches is required
for furnace alone.
2. Mechanical room by bathrooms requires
80 square inches of air (4x14 = 56
square inches).
3. Opening needs to be covered with
• 1/4 -inch mesh screen.
MECC706 Mechanical Insp 11/04/98 / / 11/04/98 PASS RC 11/05/98 J *H
•
Page No. 2 CASE HISTORY FOR CASE NO.: MEC98 -0399
MOOKI DENTAL LAB
11755 SW QUEEN ELIZABETH ST
03/02/99
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MECC725 Heating Unt Insp 09/23/98 / / / / 09/23/98 RDP
MECC730 Cooling Unt Insp 09/23/98 / / / / 09/23/98 RDP
MECC735 Duct Inspection 09/23/98 / / / / 09/23/98 RDP
MECC750 Misc. Inspection 09/23/98 / / / / 09/23/98 RDP
MECC755 «REINSPECTION» / / / / 10/30/98 2nd notice mechanical errors from PAID RC 11/02/98 JSD
103098.
Paid 98- 310505 11/02/98 jsd
MECC799 Final Inspection / / / / / / 09/15/98 GEO
MECC799 Final Inspection 09/23/98 / / 02/25/99 PASS RC 02/25/99 ROC
MECC799 Final Inspection / / / / 02/24/99 1. AIR FOR COMPRESSOR CAN NOT HAVE FAIL RC 02/24/99 ROC
CLOSURE
2. LOUVERED COVERS CANNOT BE PLACED ON
COMB. AIR INTAKE. THEY REDUCE AIR NEEDED
FOR COMBUSTION.
MECC799 Final Inspection / / / / 02/25/99
PASS .RC 02/25/99 ROC
MECC800 Case Finaled / / / / 03/02/99 03/02/99 JT
•
•