Permit r
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• CITY OF TIGARD MECHANICAL
i4,,�,:f� .,,, DEVELOPMENT SERVICES PERMIT
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y- = = --- 1 3125SWHallBlvd.,Tigard,OR97223 (503)639.4171 DATE ISSUED: 05/28/97
PARCEL: 2S1O2AA -02800
SITE ADDRESS...: 08770 SW SCOFFINS ST
SUBDIVISION • TIGARD HIGHWAY TRACTTS ZONING: CBD
BLOCK • LOT •26 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 4 DOMES. INCIN: 0
:GAS 3 -15 HP • 0 COMML. INCIN: 0
MAX INPUT: 90 BTU 15 -30 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE...: M 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 1O0K BTU: 4 <= 10000 cfm: 0 GAS OUTLETS.: 4
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Replace existing units with gas units
Owner: FEES
TUALATIN VALLEY HEALTH type amount by date recpt
14600 NW CORNELL RD PRMT $ 60.00 B 05/28/97 97- 295130
PORTLAND OR 97229 PLCK $ 15.00 B 05/28/97 97- 295130
5PCT $ 3.00 B 05/28/97 97- 295130
Phone #:
Contract or:
WILLAMETTE HVAC SERVICE
27655 SW LEPLEY LN
HILLSBORO OR 97123
Phone #: 628 -6841 $ 78.00 TOTAL
Reg #..: 000569
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 Final Inspection
within 180 days of issuance, or if work is suspended for sore
than 188 days.
/ //
Permittee S attire:
Issued By: V //
Call for inspection — 639 -4175
1
Plan Check 0 I CtDl/
CITY OF TIGARD Mechanical Permit Application Recd By g�a*
-
13125 SW HALL BLVD. Commercial and Residential / Date Rec'd S - Z
TIGARD, OR 97223 I� Date to P.E. `7 - L`6 �3
(503) 639 -4171, x304 1'1 Date to DST 5 - ,
Print or Type Permit # A1 -0c.4 01 40
Called
Incomplete or illegible applications will not be accepted
Name of Oevelo t/Projea / 7// / Description
-- a,el L' � /, �/ L Table 1A Mechanical Code - CITY PRICE AMT
Job S Address / Suite# A) Permit Fee -0- -0- 10.00
Address g77dS f �i
Bldg# C' (State Zip 1.) Furnace to 100,000 BTU 6.00
7? including ducts & vents q �y
Name (or name of business) 2.) Furnace 100,000 BTU+ (( 7.50
OwnerTw iriy 1l 7h including ducts & vents
Mailing Address // 3.) Floor Furnace 6.00
/16a70 wear � ) O including vent
ci Zip Phone 4.) Suspended heater, wall heater 6.00
, , 1 • '' TVA / or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT" p
City /State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor N8fe 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to k/iii i/ 4/9•14 #7, y/.,dc 5‘7I /C s 15-30 HP; absorb unit.5 -1 mil BTU**
issuance Mailing Addre / 9.) Boiler or comp, heat pump, air cond. 22.50
applicant 74 C5 .5 G
P G7 •' 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all /State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
1,
contractor h 9 l'7723 &28" ‘FY/ 0.) > 50 HP; absorb unit 1.75 mil BTU"
license O sj�n''�� Cont. Board Li4# . Date 11.) Air handling unit to 10,000 CFM 4.50 7 2997 •
information (o
for COT COT '' Tax or Metro # ate 12.) Air handling unit 10,000 CFM 7.50
database). q 7 & mil y 3 7
Architect Name ( ! 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City /State Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New O Addition O Alteration O Repair O 16.) Hood served by mechanical exhaust 4.50
to be done Residential O Non - residential l8(
Additional Description f wo o e /17.5' 17.) Domestic incinerators 7.50
ireeG�..& e /S �oo� 7?
/y /7h //k S/2 r1 4,s /y / /L G 9 J' Z/4"t' - 18.) Commercial or industrial type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
•
Proposed use of 21.) Clothes dryer, eta 4.50
building or property
22.) Other units 4.50
Type of fuel - oil O natural gas LPG O electric O 23.) Gas piping one to four outlets 14/ 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
•
laws.
Signature of Owner /Agent ate •SUBTOTAL
001 7 5% SURCHARGE (�
/o
ontact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL 3
T /•� Sic ri 6- S -G Pi/ /5- TOT AL
Bdst\mechpmt.doc (rev 9 •Minimum permit fee is 525 + 5% surcharge 7d- /
"Residential NC requires site plan showing placement of unit.
•
OVER- THE - COUNTER (OTC)
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Permit #: Date:
Project Name: -" GAt. ,J
Site Address: 0 S r v ScoffScoff 7"14 S 7
Description of Project: ' G.Be., �X /s7k "-/7s -r7'i 9J2 04 7c'
Class of Work: Floor Furnace: Evap Coolers:
Type of Use: Unit Heaters: Vent Fans:
Occupancy Grp: Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
/ / / / 3 -15 HP. Wood Stoves:
Max Input: 997" li Btu: Air Handling Units Clo Dryer:
Fire Dampers: � < = 10000 cfm: Oth Units:
Gas Pressure: H / P/ L > 10000 cfm: Gas Outlets: '/
No. Of Units: q
Furn < 100k Btu: y
Furn > =100k Btu:
NOTES:
Permit Extension co-- Permit Fee
v Gas Line Inspection I y' Plan Review
Mechanical Inspection 3 5% State Surcharge
17 Heating Unit Inspection Supplemental Permit
Cooling Unit Inspection Additional Permit Fee
Shaft Inspection Additional Plan Review Fee
Hood Inspection Inspection Fee
Fire Suppr Inspection Miscellaneous Fee
Duct Inspection
Fire Alarm Inspection
Fire Damper Inspection REMARKS:
Miscellaneous Inspection
Fire Alarm Inspection
/ Final Inspection
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CITY OF TIGARD BUILDING INSPECTION DIVISION
0 ..../
24 -Hour Inspection Line: 639 -4175 Business Phone: 639-4171
Date Requested: IQ ` 0 A.M. P.M. MST: 1
Location: ; (7 „_�-_.t i.., . ` .. ,■ BUP:
Tenant: r
Suite: Bldg: MEC: ! -oiS
Contractor: c j Phone: (.p 8 PLM:
Owner: Phone: ELC:
1 - ' \ Do ELR:
A !” �ek.c c'1/� �.R� , SIT:
B ING V BLDG (con't) PLUMBING C AL ELECTRICAL SITE
Site Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Runs Low Volt
Approved Approved • pprov.. Approved Approved
Appr /Sdwlk Not Approved Not Approved / t ;2. oved Not Approved Not Approved
FINAL FINAL a FINAL FINAL
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O Call for reinspection O Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: Date: 6 �� Page of