Permit A-, CITY OF TIGARD MECHAN I CAL
/401 „ ;� DEVELOPMENT SERVICES PERM IT
PERMIT # • MEC97 -0411
_ !+�
='!!.. 13125 SW Hall Blvd., Tigard, OR 97223 503 639.4171 DATE ISSUED • 10/24/97
PARCEL: 1S133DA -08600
SITE ADDRESS...: 12617 SW SNOW BRUSH CT
SUBDIVISION....: AMART SUMMERLAKE NO.2 ZONING: R -7
BLOCK • LOT :146 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/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL. TYPES 0 -3 HP....: 0 DOMES. INCIN: 0
3 -15 HP • 0 COML. 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.. : I�
NO. OF UNITS - - -- AIR HANDLING UNITS OTHER UNITS. : 1
FURN ( 100K BTU: 0 (= 10000 cfm: 0 GAS OUTLETS. : 1
FURN > =100K BTU: 0 ) 10000 cfm: 0
Remarks : Install a fireplace insert and gas piping in an existing single family
dwelling.
Owner: --------- • - - - -- FEES - - - -- - - - - - --
KENNETH A JONES type amount by date recpt
12617 SW. SNOW BRUSH COURT PRMT $ 25.00 GEO 10/24/97 97- 300367
TIGARD OR 97223 SPCT $ 1.25 GEO 10/24/97 97-300367
Phone #:
Contractor: ----- -- - - - - -•
G P & W SYSTEMS INC
732 MARBLE RD
26.25 TOTAL
WASHOUGAL WA 98671 -9601
Phone #: 360- 835 -3516
Reg #.. : 001081
REQUI RED 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 180 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.
: I�
Issue B Permittee Signature: C `�
By: T 9 ���
+++++++++++++++++++++++ + + + + + + + + + + + + + + + +-I- + +-I- + + + + + ++ + + + + + + ++-I- + + + +-I- -I- ++ ++ -I- -I-++ +-I-+ + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
+++++++++ + + + + + + + + + + + + + +- F + + + + +- I- + + + +-I- +++++- I-+++++++++ + + +- I- + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
;ITY OF TIGARD Mechanical Permit Application Recd By
13125 SW `HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # /gee 9/ - OW
Called
Incomplete or illegible applications will not be accepted
Name of DevetopmentlProlect Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suitee A) Permit Fee -0- -0- 10.00
Address IZ(017 StJ3 5 Aau) ash C.
Btdge City/State Zip B) Supplemental Permit 3.00
Ti ,w g 72_2-3
i Name (or name of business) 1.) Furnace to 100.000 BTU / 6.00 tP -'
Owner IoM � cme -S incl. ducts & vents f Si
Mailing Address 2.) Furnace 100.000 BTU + 7.50
- incl. ducts & vents
City /State Zip Phone 3.) Floor Furnace 6.00
inc. vent
Name (or n . ame of business) 4.) Suspended heater. wall heater 6.00
��� or floor mounted heater
1 Occupant Mailing Address 5.) Vent not Incl. in 3.00
appliance permit
City/State Zip Phone 6.) Boiler or comp, heat pump, air cond. 6.00
l to 3 HP; absorp unit to 100K BTU
Contractor Name 7.) Boiler or comp, heat pump, air cond. 11.00
(Prior to ' P A--l9J 5s m.S , ,..a `--- 3-15 HP; absorp unit to 500K BTU
issuance Mailing Address 8.) Boiler or comp, heat pump, air cond. 15.00
applicant 7 >L i'V\o_ lLa_ P -6- 15 -30 HP: absorp unit .5-1 mil BTU
must provide all ay/state zip Phone ?�,p 9.) Boiler or comp, heat pump, air cond. 22.50
contractor Uvc,.i)hau9 .� A - - 7 t 5 35 -351 b 30-50 HP; absorp unit 1 -1.75 mil BTU
license Cregon Consi. Cont. Board Lice Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
information 16'31'7 lc 8-11-Ta > 50 HP; absorp unit 1.75 mil BTU
for COT Cco' ^ - - Memo a Exp. Date 11.) Air handling unit to 4.50
database). 3"// 4 1 - ( -q8 10.000 CFM
Architect Name 12.) Air handling unit 7.50
10,000 CTM +
or Mailing Address 13.) Non portable 4.50
evaporate cooler
Engineer City/State Zip Phone 14.) Vent fan connected 3.00
to a single duct
Describe work Nevi Addition 0 Alteration 0 Repair 0 15.) Ventilation system not • 4.50 ,
to be done Residential< Non - residential O included in appliance permit I
Additional Description of work - 16.) Hood served by mechanical exhaust 4.50
16S- ro L1 '1 L %, Tt4 unS� , ...:11 un°
1Ak YY c7Y, U FP j 2S' , 6-r --sx.
17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrialtype 30.00
building or property e..Q-Lcs "�_ incinerator
19.) Repair units 4.50
Proposed use of 20) Woodstove 4.50
buiiding or property
21) Clothes dryer. etc. 4.50
Type of fuel - oil 0 natural gas, LPG 0 electric 0 22) Other units 4.50
I I hereby acknowledge that I have read this application, that the 23) Gas piping one to four outlets / 2.00 O� '1
information given is correct. that I am the owner or authorized agent of
the owneri plans submitted are 'n compliance with Oregon State 24) More than 4 -per outlet (each) .50
law ' _
S • na• er /Agent D ate QTY.SUBTOTAL r , i
'SUBTC T AL /j �
h ne o'crtr, r��3S
Con Person Name Phone 5% SURCHARGE
(,i c.�ns� p ►ar .-o (_,>1 lG.5 9d
PLAN REVIEW 25% OF SUBTOTAL
a`Pet - 6n r 156)
TOTAL 0 V°
i:ldstlmechpmt.doc (rev 7/96) 'Minimum permit fee is 525 + 5% surcharg
R ECEIVED
o CI 2 2 1997
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
p
/12-2-0 Date 0 AM 410 BUP
>c BLD
Location iv o r I d w Suite MEC ci 7 -6//
Contact Person Il O tfJ s K-5( CfPh PLM
Contractor Ph 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
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASSE sAaL FAIL
CHANICAL
Post & Beam
Rough In / /
Gas Line ' 1/9
Dampe s . 1
in ,
S ART 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 • I /'
Approach /Sidewalk ' J % J. A J\ IiJ A _ —. Other Date GGG ' Inspector Ext G7
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 ,,\,,/
Date Requested: / 1 13 1' 1 A.M. P.M. Igo cl Cr'
Location: ' ca l "1 9 -.( ��/L / BUP:
Tenant: Suite: Bldg: MEC:
Contractor: Phone: PLM:
Owner: Cr .P4, _ Phone: 5 -600 ELC:
I „ _ ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In eiling Water Line
Slab Framing Top Out ® ugh -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct econnect Vault
Bsmt Damp Drywall Storm Furnace ✓� Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spk1r /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
0 ')--0 -4,(_ L-- L / / ill- 5, e'r / .
A A, 4 :14,44 _ e., L : z 4 r__
•
C all for reinspection 0 Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: P-4,-- ( ' Date: / ! 3 -? 7 Page of
/6' 0
l0 'a
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 0 - 1 9 A.M. P.M. MST:
Location: 7-60 /7 X1.1,) I / I t- Ar .. te/ I - BUP:
Tenant: Suite: 7`'
Bldg: / MEC: C r 7- 0'1
Contractor: / .r. / d.ItLi(�i • • .ne: 3 '0 'd p 35' 35// PLM:
Owner: AI i AA • / ,�j Ii ! ! Phone: 5 7q_ (a ! 3 0 ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING I' CHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Pos v : a:r ■ / Cover /Service Sewer /Storm
Footing Roof UndFl/Slab ' •u R / I ' riling Water Line
Slab Framing Top Out - t JN ,, or . ough -In UG Sprinkler
Foundation Insulation Sewer - .. P Ct Reconnect Vault
Bsnrt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spk1r /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved_ Approved Approved
Appr /Sdwlk Not Approved Not Approved Not A roved ' Not Approved Not Approved
FINAL FINAL FINAL FINAL
(2) /I e e 0 C -kw,- je
"u�C.. iQi _ J (g,-,-e' �'r' - r
/ S L C / r , / G- -7� vt v .
c -- e re- 62t - u � -1.--�
O Call for reinspection O Reinspection fee of $ required xt
before next inspection O Unable to inspect
Inspector: C - Date: 0 I ' 1 ` Page of