Permit '
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ilhlo CF OF T'IGARD
PERMIT ICAL
DEVELOPMENT ������Ud�����
~=�~�~~n���o .="�"�" ~��~nn�"**m�~� PERMIT #.......: MEC98-0232
=�m■� 0125 S0/ Hall Blv� Tigard, OR9722380H639-4/7Y DATE ISSUED: 06/16/98
PARCEL: 1S125DB-05800
SITE ADDRESS...: 07190 SW SHADY LN
SUBDIVISION....: SHADY DELL NO.2 ZONING: R-4.5
BLOCK..........: LOT.............:031 JURISDICTION: TIG
__________________________ _________________ ___ ________________
CLASS OF WORK..:ALT 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....: 1 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..: 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.: 2
FURN >=100K BTU: 0 } 10000 cfm: 0
Remarks : Replace existing furnace add A/C unit and gas piping. A/C units cannot
be placed within the required setback areas.
Own -- ------------------ ------------ FEES --------------
CLARENCE L CHILSON type amount by date recpt
7190 SW SHADY LANE . PRMT $ 25.00 GEO 06/16/98 98-306580
TIGARD OR 97223 5PCT $ 1.25 GEO 06/16/98 98-306580
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Phone #:
Contractor: ---- --------------------
JACOBS HEATING & A/C
4474 SE MILWAUKIE AVE ---------------- ------------
$ 26.25 TOTAL
PORTLAND OR 97202
Phone #: 503-234-7331
Reg #..: 000014
------- 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 Heating Unt Insp __
applicable laws. All work will be done in accordance with Cooling Unt Insp
approved plans. This permit will expire if work is not started Misc. Inspection __ __
within 180 days of issuance, or if work is suspended for more Final Inspection
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. _____________________ ______________ _
_��__����___��__���_ __������_���_������_
-- ----------- ----
_
/I/ `
Issue B /�_ __________ Permittee Signature ��
_
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+ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639-4175 by 7:00 p.m. for inspections needed the next business day
+ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Plan Check #
C 11 ORTIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 SO/ S9 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit #�1�G -_ '3
Called
Incomplete or illegible applications will not be accepted
Name f Dpmenroje In / rr i/1 Description
i (' (/ � tJP IA/ ..y aali L.- 1 ' Table 1A Mechanical Code - QTY PRICE AMT
Job Street Address J Surte# A) Permit Fee -0- -0- 10.00
Address
Bldg# f City /State G Z;p _ Z � 1.) Furnace to 100,000 BTU 6.00 / „
/ ! {{� i including duds & vents (�/
Name (or name of business) / 2.) Furnace 100,000 BTU+ 7.50
Owner Cl&r(,iice CM/16674 including ducts & vents
� M / ailing Address - 3.) Floor Furnace 6.00
1 1(10 90 i r�1 aiiii L V) including vent
City/State zip I a�o�+e ri " 4.) Suspended heater, wall heater 6.00
L /G/ `�/ or floor mounted heater
Name (of of business) 5.) Vent not included in appliance permit 3.00
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Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00 /
to 3 HP; absorb unit to 100K BUT" (Q
City/State 1 (1/1.61 Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
i 3-15 HP; absorb unit to 500K BTU"
Contractor f fe.., `� ' 1 ,, 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to 15 -30 HP; absorb unit.5 -1 mil BTU**
issuance Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
applicant 4414- SE YYl I I,LOC 4 e. 30-50 HP; absorb unit 1- 1.75mil BTU
must provide all City /State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
• contractor Q-y'`d , OF 0 112_02 , 34- - 1'3' ■ > 50 HP; absorb unit 1.75 mil BTU•' _
license Oregon Const. Cont. Board Lic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
information 1 /111 1,1_q --Cj$
for COT COT Business Tax or Metro # Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database). 12._i05
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
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Engineer City /State zip - Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 AlteratioV Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done ResidentiO Non - residential 0
Additional Description of work 17.) Domestic incinerators 7.50
18.) Commercial or industrial type ' 30.00
Incinerator
Existing use of ! � o 19.) Repair units 4.50
�
building or property Si (, t�
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas' LPG 0 electric 0 23.) Gas piping one to four outlets 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
Signatu f t>wr /Agen Date *SUBTOTAL r
/ VU • 5% SURCHARGE ),,-24-5
Contact erson Name Phone PLAN REVIEW 25% OF SUBTOTAL
TOTAL
2/.
i:ldst4nechprrit.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge
- Residential A/C requires site plan showing placement of unit.
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
(a/g Date Requested - 7 -9 g AM PM BLD
Location 7�D / Suite MEC $( 1 P — vc:L •
Contact Person �.P^ Ph PLM
Contractor
/(I/ Ph -3 'f- - 733/ SWR
BUILDING Tenant/Owner C6A,Auc , ELC
Retaining Wall ELR •
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall Y . /
Fire Sprinkler . CLA COLw' —'0[ ,A0 /1"__
Fire Alarm ��
Susp'd Ceiling � �1C. / A �/\ t21' Z. /
Roof
Misc: A J �' M' L � A _ 1L_AAd� f L A 4Amm.
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab '5')
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS.--RAT FAIL •
t;ECHANICAL
Post & Beam
Smo e Dampers
Fin -
PART FAIL
CTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
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 / /l
Other Date 1 (it. Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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