Permit •
4
P4 CITY OF TIGARD
MECHANICAL PERMIT
A,, r� DEVELOPMENT SERVICES PERMIT #: MEC2000 -00131
r �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/25/00
PARCEL: 1S125DB-08300
SITE ADDRESS: 07230 SW SHADY CT
SUBDIVISION: SHADY DELL NO.2 ZONING: R -4.5
BLOCK: LOT: 056 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - .3 HP: 1 DOMES. INCIN: •
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Replace existing gas furnace with like kind, install gas piping and air conditioning unit. NC units cannot be
placed within the required setback areas. .
Owner: FEES
DAN BURLEIGH Type By Date Amount Receipt
7230 SW SHADY COURT PRMT GEO 4/25/00 $50.00 001694
TIGARD, OR 97223 5PCT GEO 4/25/00 $4.00 001694
Total $54.00
Phone:
Contractor:
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE.
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Gas Line Insp •
Phone: 503 - 234 -7331 Heating Unt Insp
Reg #: LIC 1441 Cooling Unt Insp
Final Inspection
• QRU3INAL
•
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other 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 in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtai opies o ese or direct questions to OUNC by calling 03)246 -9189.
Issue By: ��' �- Permittee Signature: /
e ,
Call (503) 9-4175 by 7:00 P.M. for inspections needed the next business day
Plan Che
CITY -OF TIGARD Mechanical Permit Application Rec'd By
1 3125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit #ntkeR0 00/3/
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
h Jf� N u - 1 c Table 1A Mechanical Code Qty Price Amt
Job Street Address `� Suite# A) Permit Fee 16.00
1) Furnace to 100,000 BTU
Address '113 O s w s H �i�y e.�- including ducts & vents see footnote 1,2 / 9.65 9.6 S
Bldg# - City/State Zip 2) Furnace 100,000 BTU+
T riq G 2 S7a 3 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner DA �� (p including vent see footnote 1,2 9.65
Mailing Address
Lb 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 9.65
707 30 5 W S I-I An Li (r T. 5) Vent not included in appliance permit 4.75
City/State Zip Phone Check all that apply: 'Boiler Heat Air
714Q fel GEC c i'T,a a3 - 7 b S► - 9 0(4, For items 6 -10, see or Pump Cond Qty Price Amt
Na ( or name of business) footnotes 1,2 Comp
• 6) <3HP;absorb unit to
100K BTU ' / 9.65 (0 S
Occupant Mailing Address 7) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
City/State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Name 9) 30 -50 HP; absorb
Contractor _ unit 1 -1.75 mil BTU 36.00
,) Vg COPS 14- eC1-t d e__ 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy WI N SE. 1, II. tJn ..jl t e flue. 11 Air handling unit to 10,000 CFM
of all licenses City/State 1 Zip Phone 7.00
are required if POY+Ir,,,-.C') D� 9.140a L/- - 7 g3 / 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.75
database / y' p 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct
4.75
or Mailing Address
15) Ventilation system not included in
appliance permit 7.00
Engineer City /State Zip Phone 16) Hood served by mechanical exhaust
7.00 -
Describe work to be done: 17) Domestic incinerators
12.00
New 0 Repair 0 Replace with like kind: Yes,No O 18) Commercial or industrial type incinerator
Residentialp' Commercial 0 48.25
19) Repair units
Additional information or description of work: 8.40
20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 . ( 3.75 .3.7
Type of fuel: oil 0 natural gasy LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL . 39.c6-
I hereby acknowledge that I have read this application, that the information Qj A SURCHARGE - .q, /a
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL , .
the ^ own , - er • that fans submitted itt in compliance with Oregon State laws. Required for ALL commercial permits only
. 9'� A _ ftP , 0 t.d. J . / s . U C) TOTAL _
Signature of Own en Date " r ° .5/07/
/ Other Inspections and Fees:
l k , ✓ [ ,2 7 3 � / 1. Inspections coons outside of normal business hours (mininum charge -two
Contact Person a Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge -one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. *State Contractor Boiler Certification required
"Residential NC requires site plan showing placement of unit
I:'irnechperm.doc rev 02/4/99
aaaC-/
■ I
• 1 ') kkftt i.,.
4-
1 - -
I .
C.
ii 3 49 0
C r
.... ....-. ___, A. oN ........
0
. .
+ —
• ....-- .
)
2
, ]
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested .S /a) / °° AM PM n BLD
Location ^) 2,3 h S Ak LeO Suite C MEC WOO -00) 3/
Contact Person r J ) Ph 2 fl- I ujjs PLM -oo 12,S
Contractor (. vw Ph 7(O SWR
BUILDING Tenant/Owner 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
Fire Sprinkler
Fire Alarm
•
Susp'd Ceiling
Roof
Misc:
•
Final
PASS PART FAIL
t\ PLUMBIN)
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Drains
FAIL
Post & Beam
Rough In
Gas Line
Smo_ ke Dampers
rn
PART FAIL
ELECTRICAL
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 3/1 ,{ �r
Other Date I! Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.