Permit CITY TIGARD MECHANICAL PERMIT
r� DEVELOPMENT SERVICES PERMIT #: MEC1999 -00259
j"'�' l�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/16/99
PARCEL: 2S103CD -04401
SITE ADDRESS: 11675 SW TERRACE TRAILS DR
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT 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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of a central air conditioner. A/C units cannot be placed within the required set back areas.
Owner: FEES
GARY SIEG Type By Date Amount Receipt
11675 SW TERRACE TRAILS PRMT GEO 6/16/99 $50.00 99- 316150
TIGARD, OR 97223 5PCT GEO 6/16/99 $2.50 99- 316150
Total $52.50
Phone: 520 -7676
Contractor:
OWNER
REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: Final Inspection
Reg #:
ORIGINAL
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 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 • th- rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: 4 Permittee Signature: / /
Call (503 39 -4175 by 7:00 P.M. for inspections needed the next business day G
• Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By
-13125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 V Date to DS y T C�,
Print or Type Permit # AteIK1 -60751
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
S ,6C �� Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee s ` - ;" 16.00
Address 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 9.65
Bldg# City/State Zip 2) Furnace 100,000 BTU+
including ducts & vents see footnote 1,2 12.00
Name ((or name of business) 3) Floor Furnace -
Owner G4, Y S /E-ri including vent see footnote 1,2 9.65
4) Suspended heater, wall heater
Mailing Address or floor mounted heater see footnote 1,2 9.65
//G 7S S'' 7 - e'Vre 74/p 5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
7?/' ale . 7 7 223 ...5 74 For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
Sr �y -pi ✓c 6) <3HP;absorb unit to
100K BTU ) 1 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Contractor Name 9) 30 -50 HP; absorb
unit 1 -1.75 mil BTU 36.00
10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy 11 Air handling unit to 10,000 CFM
of all licenses City /State Zip Phone 7.00
are required if 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.75
database 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct
M ailing Address 4.75
or 15) Ventilation system not included in
appliance permit 7.00
Engineer City/State Zip Phone 16) Hood served by mechanical exhaust
_ 7.00
Describe work to be done: 17) Domestic incinerators
12.00
New"( Repair 0 • Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator
Residential}, Commercial 0 48.25
19) Repair units
Additional information or description of work: . • 8.40
T,1)7 /7 CiPq f 7 Al.,: C ,o%,5a. v 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 gas 0 LPG 0 electric 0 22) More than 4 -per outlet (eac .75
Minimum Permit Fee $50.00 SUBTOTAL U
I hereby acknowledge that I have read this application, that the information 5% SURCHARGE MN
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL . "' V,V a,.,
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only 14 ,F , ; "
TOTAL - *.,
sv
Signature of Owner /Agent Date > �=
Other Inspections and Fees:
-/44-9, 1. Inspections outside of normal business hours (mininum charge -two
Contact rson Nam ' Phone hours) $50.00 per hour
� ��Y :S /6�� .57.2 e- - 7L; .7.4. 2. Inspections for which no fee is specifically indicated (minimum
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 NC requires site plan showing placement of unit
I:knechperm.doc rev 02/4/99
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Wood Fence Catch
Gary Sieg
, Basin
,__________
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TAX LOT 2S13CD-04401 Site Plan for house addition and
,; , 1 1675 SW TERRACE TRAILS DR.
•,.: , -,
_ A OR additional detached garage
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ZONED R4.5
_ Rain Drains to tie into existing system
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