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Permit CITY OF T MECHAN I CAL 1 , 4 ��1, DEVELOPMENT SERVI PERMIT #PERMIT ° MEC98— 304 DATE ISSUED: 07/30/98 PARCEL: 2S1O3DB -03800 SITE ADDRESS...: 11275 SW QUELLE PL SUBDIVISION GENESIS NO. 2 ZONING: R -4.5 BLOCK • LOT....... ...... :036 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/O 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 COML. INCIN: 0 MAX INPUT: 0 BTU 15 -30 HP O 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.: 1 FURN t 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1 FURN > =1O0K BTU: 0 > 10000 cfm: 0 Remarks : Installation of gas fireplace and gas' piping. Owner: FEES GERALD J MOORE type amount by date recpt 11275 SW QUELLE PLACE PRMT $ 25.00 DEB 07/30/98 98- 307856 TIGARD OR 97223 5PCT $ 1.25 DEB 07/30/98 98- 307856 Phone #: Contract or: D GRAVELLE DAVIS ALLEN GRAVELLE 2906 NE 53RD $ 26.25 TOTAL PORTLAND OR 97213 Phone #: 287 -2368 Reg 4..: 123541 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 1c., 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. r 0.4#4, / // Iss a By: Permittee Signature: _ ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for inspections needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ CITY OF TIGARD Mechanical Permit Application Reed 8'j, 13125 SW HALL BLVD. Commercial and Residential Date Rec'd 7' if TIGARD, OR 97223 Date to P.E. (503) 639 -4171, x304 Date to DST Print or Type Permit# Htec0fr Incomplete or illegible applications will not be accepted Called Name of Development/Project Description a.•Or J Y.A. ® t 2 - e Table 1A Mechanical Code Qty Price Amt Job Street Address Suite# A) Permit Fee 10.00 Address I 1 a 6 Que∎ `- C-+ 1) Furnace to 100,000 BTU including ducts & vents 6.00 Bldg# City /State t Zip , \X 2) Furnace 100,000 BTU+ �\ 0.Y including ducts & vents 7.50 Name (or name of business) 3) Floor Furnace Owner Z.Q,•(\('` 1/‘©c5)Y---C2— including vent 6.00 Mailing Address 4) Suspended heater, wall heater 1 i 2:-Tc 2:-T S LL-) Q < k or floor mounted heater 6.00 5) Vent not included in appliance permit Cit /State Zip Phone 3.00 1 eft..‘A. % tozo -SS7- CHECK ALL 'Boiler Heat Air Nam r name of business) THAT APPLY: or Pump Cond Qty Price Amt .. Comp • Occupant Mailing Address 6) <3HP;absorb 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 • Contractor Name unit .5-1 mil BTU 15.00 A ' �� `e_, 9) 30 -50 HP; t BTU Y unit 1 -1.75 mil BTU 22.50 Prior to permit Ma A ress r 1 ��� 10) >5OHP; absorb unit issuance, a copy ' � , N S 3 >1.75 mil BTU 37.50 of all licenses state Zip Phone=' --- 11) Air handling unit to 10,000 CFM are required if © Q ef 'T72_c 3 .*: 4.50 expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 12) Air handling unit 10,000 CFM+ database I Z j5 L{ I (9 —7 — IOC) 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 ResidentiaK Commercial 0 18) Commercial or industrial type incinerator . 30.00 Additional information or description of work: _ . 19) Repair units 4.50 20) saQ'stove— II / ( s i(3t)%_12 . __ 4.50 qac cw_a_tp l +- L. 1 ��, 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 `/ • given is correct, that I am the owner or authorized agent of J( 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/ • • ent Date _ "„ z , A -. ae Minimum Permit Fee $25.00 SUBTOTAL O P- S 5 % SURCHARGE ., l " C. : 0040 .ame Phone PLAN REVIEW 25% OF SUBTOTAL Required for ALL commercial permits only�,��� ; . ik % C C&J Q ` \` cs 2 3 6 s TOTA . a, .. . A �/ ,r `State Contractor Boiler Certification required ""Residential NC requires site plan showing placement of unit I:\mechperm.doc rev 07/20/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 _ BUP 3-0 /l ' % ' V J Date Requested - 7 -- cif/ AM / PM .)C BLD _ Location / L - 2 - 7 5 / r 4 V c.ti c1-„ i _ h _ Suite MEC / '� �' � I Contact Person t Ph / PLM Contractor i�fLC� ��;,. Ph SWR BUILDING : "� : Tenant/Owner � , `71a c. ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Ina Sheath /Shear a --y� 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 ( MECHANICAL Post & Beam j Gas. Line Smoke Dampers Final PASS PART FAIL ELECTRICAL . a; Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS 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 A roach /Sidewalk Other Dat ' 1 3 ( ? Inspect E x t Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.