Permit CITY OF T MECHAN I CAL
• i �n,n .,,{ \ DEVELOPMENT SERVICES PERMIT
'�1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE I ISSUED: 08 / 19 - 035 9
PARCEL: 25111CA -02900
SITE ADDRESS...: 15498 SW SUMMERFIELD LN
SUBDIVISION • SUMMERFIELD NO.7 ZONING: R -7
BLOCK • LOT :376 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.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 ) 10000 cfm: 0
Remarks: Mechanical alteration for residence.
Owner: FEES
DICK PLILER type amount by date recpt
15498 SW SUMMERFIELD LN PRMT $ 25. DLH 08/19/98 98- 308426
TIGARD OR 97224 5PCT $ 1.25 DLH 08/19/98 98- 308426
Phone #: 620 -9060
Contract or:
SPECIALTY HEATING & FABRICATIO
9528 SW TIGARD ST
$ 26.25 TOTAL
TIGARD OR 97223
Phone #: 620 -5643
Reg #..: 006657
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 Heating Unt Insp
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.
Issue By:
/125g2",,...________
Permittee Signature:P lr6 .4J
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By A
13125 SW HALL BLVD. Commercial and Residential Date Recd 4 ti
- TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit# / 6-, 59
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suit A) Permit Fee 10.00
Address /54 q SO 1) Furnace to 100,000 BTU
including ducts & vents ( 6.00
Bldg Sit /State Zip 2) Furnace 100,000 BTU+
I Lql d. Ole 9 ( including ducts & vents 7.50
Name (or name of usiness) �J1 3) Floor Furnace
Owner nie 0 / (f( including vent 6.00
Mailing Address 4) Suspended heater, wall heater
/15 - � S � fuma � floor mounted 6.00
lY' q 8 3 dJLIJ ` � 6 / � '7, 5) Vent not included in appliance in appliance permit
City /State Zip Phone 3.00
/ ( diC 97Q b 7 3 Cao� PG 9 CHECK ALL 'Boiler Heat Air
Nam or name of business) THAT APPLY: or Pump Cond Qty Price Amt
Comp
w ILL,/ 6) <3HP;absorb unit to
Occupant Mailing Address 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
I
Contractor Name unit .5-1 mil BTU 15.00
9) 30 -50 HP; absorb
�peeia 1-11 (IL . ir iI rd unit 1 -1.75 mil BTU 22.50
Prior to permit Mailing Address [[ 10) >50HP; absorb unit
issuance, a copy q d R cd l ( y aid �TL >1.75 mil BTU 37.50
of all licenses City /State - U Z phone 11) Air handling unit to 10,000 CFM
are required if f t , 57 ar e 7 3 (0 4.50
ex ired in COT or Const. C ont. Board Lic.# Ex `�j P . pate 12) Air unit 10,000 CFM+
P handling
database / ! ! / ) handlin 7.50
Architect Name 99 13) Non - portable evaporate cooler
iftl ,A 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 /No O 7.50
Residential lir 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 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
given is correct, that I am the owner or authorized agent of 1 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 n/�
Minimum Permit Fee $25.00 SUBTOTAL 0`� r 71 ?
- 0 ' t . 4 . / - Mr--4 1 -P-4:1 ) O 1 q 8 It 5% SURCHARGE i • g-5
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
�/�� iLm �/ '/ Required for ALL commercial permits only
S
•
�(! 1 d D (L 5 (p n ` 56o «-- TOTAL 94)f d �
*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: 639 -4175 Business Line: 639 -4171
G BUP
10/)--- Date Requested q `40 AM PM BLD
Location Z ' 4 I ,,! ; !ak, J - . J cr ._ Suite it — °35Y
Contact Person ' l' / . J dL4 Ph 'fO 6 O • LM
Contractor ,eACI • Ph ( 5j(3 SWR
BUILDING Tenant/Owner ai "Jr �Q� ELC
Retaining Wall ELR
Footing Access:
Foundation xxoneuniud J, PL j/ L 1R 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
T FAIL
ECHANICAL`
Pos & beam
Rough In
Gas Line
ke Dampers
PART FAIL
EL RICAL
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 rp ,
Other Date "� Q 1 5 ) Inspector C1 E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.