Permit A CITY OF TIGARDO MECHANICAL PERMIT
, DEVELOPMENT SERVICES �/
"
PERMIT #: MEC2000 -00037
-- r - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 1 �' DATE ISSUED: 01/28/2000
�j PARCEL: 1S133DA-06400
SITE ADDRESS: 11015 SW SUMMER LAKE DR ��/
SUBDIVISION: AMART SUMMERLAKE
e ZONING: R -7
BLOCK: LOT: 086 JURISDICTION: TIG
• CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replacement of gas furnace and installation of new a/c unit. Placement of a/c unit must comply with standard
setbacks.
Owner: FEES
THOMAS H. FORCE Type By Date Amount Receipt
11015 SW SUMMER LAKE DR 5PCT DST 01/28/20( $4.00 00- 321467
TIGARD, OR 97223 PRMT DST 01/28/20C $50.00 00- 321467
Total $54.00
Phone: -
Contractor:
BELL HEATING
(GREG MILLETT)
15550 SE PIAZZA AVE REQUIRED INSPECTIONS
CLACKAMAS, OR 97015 Heating Unt Insp
Phone: 656 -1184 Cooling Unt Insp
Reg #: LIC 447 Final Inspection
PLM 3 -286PB
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 rule, adopted in the Oregon
Utilit • n Center. Those rules are set forth in OAR 952 - 001 -0010 t •ugh OAR 952 - 001 -0080.
Yo may obtain c pies of t /s- - . or •irect questions to OUNC by cal; • '41'411r. ' •-9189.
Iss By: _' _� 4 ��' ,1 ,6_,„ > Permittee Signatu '° jt/ / �j� i � :
Call (503) • 39 -4175 by 7:00 P.M. for inspections nee . ed the next business day
•
Plan eck #
_CITY.OF TIGARD Mechanical Permit Application Recd )....,..)-0
13125 SW HALL BLVD. Commercial and Residential Date Recd / - AS1 -00
TIGARD, OR 97223 Date to P.E. -
(503) 639 -4171, x304 Date to DST I
Print or Type
Permit # __ ___ ___ c1
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address f ( Suite# A) Permit Fee - 16.00
Address i D /� 0c ri llot a)1 1) Furnace to 100,000 BTU / �,
�/ U Iy1 including ducts & vents see footnote 1,2 9.65 �t 6
Bldg# City /State Zip 2) Furnace 100,000 BTU+
] 2D 9 7223 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner initL "'`f ' Y ). �L° including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
/ /0 /s cc(/7�°1 floor mounted heater see footnote 1,2 9.65
�1�° / Pi Vent Vent not included in appliance permit 4.75
City/State Zip Phone Check all that apply: *Boiler Heat Air
`p r • (5 ;?4 - For items 6 -10, see or Pump Cond Qty Price Amt
me (or name of business footnotes 1,2 Comp
6) <3HP;absorb unit to 0
100K BTU r 9.65
Occupant Mailing • .d - 7) 3-15 HP;absorb unit
100k to 500k BTU 17.65
City /State d ip Phone ' 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Contractor Name un�a 1.75 mil BTU 36.00
E 2L h - t 10) >50HP; absorb unit
Prior to permit Mailin Address y >1.75 mil BTU 60.15
issuance, a copy i 5556 � (��i(} Atj 11 Air handling unit to 10,000 CFM
of all licenses ity /Stat ^
e, l Zip Phone `I 7.00
are required if t4 L e 17n< c to g,- I � 12) Air handling unit 10,000 CFM+
expired in COT Oregon const. Cont. Board Lic.# Exp. Date 11.75
+
database 4 47 _ 6E. tD 2-1" 0 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 cy.stedi Zip Phone 16) Hood served by mechanical exhaust
7.00 -
Describe work to be done: 17) Domestic incinerators
12.00
New X Repair 0 Replace with like kind: Yes& No O 18) Commercial or industrial type incinerator
Residential of Commercial O 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
Type of fuel: oil 0 natural gap 6_ LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL O
I hereby acknowledge that I have read this application, that the information / f '7 o SURCHARGE C1. Cl
given is correct, that I am the owner or authorized agent of PLAN REVIE 25% OF SUBTOTAL
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
TOTAL � Q Q
Signature •.;(• • •. • gent Date
!��'' / Other Inspections and Fees:
/ /9/ 2� 1 . Inspections outside of normal business hours (mininum charge -two
ontact Person Name I Phone hours) $50.00 per hour
C 2. Inspections for which no fee is specifically indicated (minimum
,s �� J r 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 A/C requires site plan showing placement of unit
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4
A CITY OF TIGARD MECHANICAL PERMIT
,� DEVELOPMENT SERVICES
PERMIT #: MEC2000 -00037
� ,.� �! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/28/00
PARCEL: 1 S133DA -06400
SITE ADDRESS: 11015 SW SUMMER LAKE DR
SUBDIVISION: AMART SUMMERLAKE ZONING: R -7
BLOCK: LOT: 086 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
LPG 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:
Remarks: Replacement of gas furnace and installation of new a/c unit. Placement of a/c unit must comply with standard
setbacks.
Owner: FEES
HOMAS H. FORCE Type By Date Amount Receipt
1015 SW SUMMER LAKE DR 5PCT DST 1/28/00 $4.00 00- 321467
IGARD, OR 97223 PRMT DST 1/28/00 $50.00 00- 321467
Phone:
Total $54.00
Contractor:
ELL HEATING
GREG MILLETT)
5550 SE PIAZZA AVE REQUIRED INSPECTIONS
LACKAMAS, OR 97015
Heating Unt lnsp
Phone: -1184 Cooling Unt Insp
Reg #: LIC 447 Final Inspection
PLM 3 -286PB
P
Li
a3thdX3 8
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes O
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 1
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 obtain copies of these rules or direct questions to OUNC by
calling (503)246 -9189.
las § Issue By: Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Iiii
V
. 4
BUP - Building Permit ELC - Electrical Permit
J Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing -4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing .4 Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line
Engineered soils Mechanical rough -in •
Welding Lab Final Fire damper CC��
Concrete Lab Final Duct work LD" P pp ,Fn
Bolting Lab Final Smoke detector 3/ 5
Fireproofing Lab Final Mechanical final ( BLS)
Structural observation
Final inspection
PLM - Plumbing Permit
Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
4 Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin /Manhole SWR - Sewer Permit
Engineered soils J Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR ELC, ELR, MEC SIT PERMITS