Permit CITY OF TIGARD MECHANICAL
a DEVELOPMENT SERV PERMIT
�• PERMIT # MEC98 -0471
DATE ISSUED: 10/22/98
PARCEL: 1S133AD- 12200
SITE ADDRESS...: 11329 SW SUMMER LAKE DR
SUBDIVISION • SUMMER LAKE ZONING: R -7
BLOCK • LOT •003 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 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 < 1O0K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =1O0K BTU: 0 ) 10000 cfm: 0
Remarks : Replace existing gas funrnace.
Owner: FEES
R SMITH & S CADELL type amount by date recpt
11329 SW SUMMERLAKE RD PRMT $ 25.00 GEO 10/22/98 98- 310222
TIGARD OR 97223 SPCT $ 1.25 GEO 10/22/98 98- 310222
Phone #:
Contractor:
ROBBEN & SONS HEATING
2300 SE 7TH AVE
P 0 BOX 14867 $ 26.25 TOTAL
PORTLAND OR 97214
Phone #: 233 -5841
Reg #.. : 001884
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Heating Unt Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 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. _
-A��
41011r/
Issue By Permittee Signature-- w • %��
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
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 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 #7, c7 76 c U 2/
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address S e# A) Permit Fee -0- -0- 10.00
Address 1L31 9 sa ntn a
Bldg# City /State Zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents
Name (or name of businpss 2.) Furnace 100,000 BTU+ 7.50
Owner ice', (`n' C)017-: including ducts & vents
nit /in�gfgr/Bss�U) 3.) Floor Furnace 6.00
�/ V (/ 1 &AI-a/Cad includ ing vent
\ C tate Zip Phone 4.) Suspended heater, wall heater 6.00
„�' or floor mounted heater
Name name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City /State Zip I Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor _ N -' - i 8.) Boiler or comp, heat pump, air cond. 15.00
i /'r Ii. 15-30 HP; absorb uniL5 -1 mil BTU"
Prior to permit M. ling Address Boiler or comp, heat pump, air cond. 22.50 tre issuance, a copy / / 71 / 9. 30-50 HP; absorb unit 1- 1.75mil BTU" •
of all licenses d) .te Zip Ph A - 10.) Boiler or comp, heat pump, air cond. 37.50
are required if - of 01 J / , ..7� / > 50 HP; absorb unit 1.75 mil BTU"
expired in COT • regos con �� a rd Lic.# Exp. at99� 11.) Air handling unit to 10,000 CFM 4.50
database � j
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City /State Zip I Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residenti Non - residential 0
Additional Description of wo : 17.) Domestic incinerators 7.50
TP ° 14 io z/ 5l / rtj4- 18 . Commercial or industrial
4772 Af,v dy
/�� 18.) type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural-gas 0 LPG 0 electric 0 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, tha : - submitted are in compliance with Oregon State • QTY. SUBTOTAL
laws.
•
Signatu = of Owner • • _ /'/ Date *SUBTOTAL
!Ash 5 %SURCHARGE
�, f / ` ,/ � 5 -
Con erson N - me Phone 6 T PLAN REVIEW 25% OF SUBTOTAL
TOTAL _, .,75---
i:\rnechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit.
03/03/2000 Activities for Case #: MEC98- 00 •
8:14:45 AM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 10/22/1998 GEO RECD DST 10/22/1998
MECA008 Create Permit 10/22/1998 GEO DONE DST 10/22/1998
MECA799 Final Inspection 10/23/1998 KS PASS J'H 10/26/1998
MECA725 Heating Unt lnsp 10/22/1998 10/23/1998 KS PASS J'H 10/26/1998
MECA060 (F) Issue permit 10/22/1998 GEO PASS DST 10/22/1998
MECA800 Case Fineled 10/23/1998 KS PASS J *H 10/26/1998
•
•
•
Page 1 of 1