Permit OF TIGARD CITY MECHANICAL
PERMIT
� DEVELOPMENT SERVICES PE R MI ISSUED: 11/24E98 -0533
PARCEL: 1S133AD -13900
SITE ADDRESS...: 12701 SW SORREL DOCK CT
SUBDIVISION • SUMMER LAKE ZONING: R -7
BLOCK • LOT °020 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
:GAS 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.: 1
FURN < 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN ) =1O0K BTU: 0 > 10000 cfm: 0
Remarks: Fernandez - gas piping and logs
Owner: FEES
MR & MRS FERNANDEZ type amount by date recpt
12701 SW SORREL DOCK CT PRMT $ 25. 00 JSD 11/24/98 98- 311064
TIGARD OR 97223 SPCT $ 1.25 JSD 11/24/98 98- 311064
Phone #:
Contract or:
ALADIN HEATING & A/C
1924 SW 32ND STREET
26.25 TOTAL
GRESHAM OR 97080 -8500
Phone #: 618 -8311
Reg #..: 000440
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 Final Inspection
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 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.
* 4,
Issue B : %� Permittee Signature: '
.i�
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd B
13125 SW HALL BLVD. Commercial and Residential Date Rec'd /l of •
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # /ACC 9g 05 33
Incomplete or illegible applications will not be accepted Called di --
Name of Development/Project Description
IAA ✓5' fY � Table 1A Mechanical Code Qty Price Amt
• Job Street Address y - Suite# A) Permit Fee 10.00
Address 1 2 7 U I S�' c 1) Furnace to 100,000 BTU
including ducts & vents 6.00
Bldg# City/State Zip 2) Furnace 100,000 BTU+
TT 5 0 97 7-2-3 including ducts & vents 7.50
Name (or name of business) / 3) Floor Furnace
- Owner GK v - h y including vent 6.00
Mailing Address d' 4) Suspended heater, wall heater .
('L"7 of $o - r e �d K or floor mounted heater 6.00
5) Vent not included in appliance permit
City/State Zip Phone 3.00
CHECK ALL - *Boiler Heat Air
Name (or 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
I 9) /; .1\ / / +rv 9) 30 -50 HP; absorb
v�Ur tt unit 1 -1.75 mil BTU 22.50
Prior to permit Mailing Address 10) >50HP; absorb unit
issuance, a copy / 9 2.41 S. 3 Z 5+ >1.75 mil BTU 37.50
of all licenses City/State Zip - Phone 11) Air handling unit to 10,000 CFM
are required if 62. v�s1` ®1-• 9707c (, I F -73 I I 4.50
expired in COT Oregon Cons!. Cont. Board Lic.# Exp. Date 12) Air handling unit 10,000 CFM+
database c iy 0 7 r- Gb 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
Residential 0 Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
4.50
20) Wood stove
4.50
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gas k4. 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 6 i
given is correct, that I am the owner or authorized agent of ' 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 /Agent Date , r/
Minimum Permit Fee $25.00 SUBTOTAL cr 7
- I 1---/- `(- 9 r
5% SURCHARGE 7'
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
Required for ALL commercial permits only
6 A -e K' C--1 Q A/ 55 / 1( S 3 Z ? TOTAL a' "-
*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: 6394175 Business Line: 639 -4171 BUP
4 9wo-3 Date Requested //'310 AM BLD
Location 12.7D1 -4W .5 Suite p MEC '053
Contact Person ? Ph 576 -5.320 Ce' -C
Contractor ,Z).1.1--5/70 OO-- Gfi - R
BUILDING Tenant/Owner `K.+ `Z OO- T/J /GL %
Retaining Wall
Footing Acce s: �, /� j , (� �7
Foundation cce CGZ b- b /(J"' o i FPS
Ftg Drain 7� SGN
Crawl Drain Inspection Not // . %
Slab ' � ` ]► SIT
Post & Beam • / . •�� / � L J � ��/
Ext Sheath /Shear ` i ,4:
Int Sheath /Shear
Framing i / :l�l,`rmar 'iti'r/4ii •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler / t nk 5 tom. = 1 8
Fire Alarm
Susp'd Ceiling !S btz iAui1rr S.
Roof
Misc: /iv5r A
Final
PASS PART FAIL t—s .— n x
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
�AS PARL FAIL
Pos
Rough In
/ 441Line 4 '' •
Smoke Dampers '.
nal
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 Inspector Da / Y� 2
X n specor ,
Other t Ext
Final
. PASS PART FAIL DO NOT REMOVE this inspection record from the job site.