Permit • CITY OF TIGARD MECHANICAL
, ;1 ' DEVELOPMENT SERVICES PERMIT
'�I' PERMIT # • MEC97 -0209
"� 1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 06/23/97
PARCEL: 2S1 14B —B 123
SITE ADDRESS...: 10436 SW TITAN LN
SUBDIVISION • ZONING:
BLOCK • LOT • JURISDICTION:
CLASS OF WORK..:NEW 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 ( 100K BTU: 0 (= 10000 cfm: 1 GAS OUTLETS.: 0
FURN ) =100K BTU: 0 ) 10000 cfm: 0
Remarks : add 1 air handling unit / air conditioning units cannot be placed
inside setbacks
Owner: FEES
JOSHUA GERTH type amount by date recpt
10436 SW TITAN LAND PRMT $ 25.00 GEO 06/23/97 97- 296329
TIGARD OR 97224 5PCT $ 1.25 GEO 06/23/97 97- 296329
•
Phone *:
•
Contract or:
ROSE HEATING CO
9945 NE 6TH DR
$ 26.25 TOTAL
PORTLAND OR 97211
Phone #: 503- 283 -•5183
Reg #..: 000020
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Ins p
applicable laws. All work will be done in accordance with Cooling 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 -8010 through OAR 952-001 -8080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
/ d /
Issue By: 4 i - . _7 Permittee Signature:
Y 9
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY OF TiGARD Mechanical Permit Application Recd By
13125 HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E,
(503) 639 -4171, x304 Data to DST
04\--7-c:A9-1 Print or Type Permit #•�F�9 - o ao
/ Incomplete or illegible applications will not be accepted Called
X10 P \C tN
Name Of pevelOpment/Proleet Description
Table 1A Mechanical Code QTY PRICE AM1
Job Street Aearesa Suited A) Permit Fee -0- -0- 10.00
Address o Su w Lit.
Biagio Ciiy/siate zip B) Supplemental Permit 3.00
In _ wla CL -
Name (or name of business) 1.) FumaCe to 100,000 BTU 6.00
Owner incl. ducts & vents .
Mailing Aaaress 2.) Furnace 100,000 BTU + 7.50
incl. duels & vents _
City /State Zip Phone 3.) Floor Furnace 6.00
incl. vent
Name (or name of business) - 4.) Suspended heater, wall heater 6.00
or floor mounted heater
Occupant Mailing Address - - 5.) Vent not incl. in 3.00
appliance permit
city/State zp Phone 6.) Boller or comp, heat pump, air cond. 6.00
to 3 HP: absorp unit to 100K BTU
�jernee 7.) Boiler or comp, heat pump, air coed, 11.00
^�� - -�L- �nt • 3-15 HP; absorp unit to 500K BTU
Contractor Mailing Aearese 5,) Boiler or comp, heat pump, air cond. 15.00
S NEI o ' . 15-30 HP; absorp unit .5.1 mil BTU
Attach copy of Iti /State Zip Phone 9.) Boiler or comp, heat pump, air Bond. 22.50
Current Licenses Q , "=1 1 11 -Izi 30-50 HP; absorp unit 1 -1,75 mil BTU
Oregon Conat, Cont. Board Ue.e Exp. Cato 10.) Boiler or comp, heat pump, air cond. 37.50
_ 1 1 a a 1 a 50 HP: absorp unit 1.75 mil BTU
C o Business Tax or men x o at q 11.) Air handling un' to 4.50
I 10,000 CFM is -- % y
Architect Name 12.) Air handling unit
7.50
10,000 CTM +
Or Mailing Address 13.) Non portable
4.50
evaporate cooler
Engineer Crty/State zip Phone 14,) Vent fan connected 3
to a single duct
Describe work New 0 Addition 0 Alteration 0 Repair O 15.) Ventilation system not 4.50
to be done Residential 0 Non - residential 0 included in appliance permit
Additional Description of work 16.) Hood Served by
E1- \\ t � ` V-- CJ N( `C■ mechanical exhaust 4.50
i V • 17) Domestic incinerators 7.50
Existing use of 18.) Commercial or Industrial 30.00
building or property _ type incinerator
19.) Clothes dryers, etc. 4,50
Proposed use of 20) Other units 4.50
building or property
Type of fuel - Oil 0 natural gas O LPG 0 electric 0 21) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application, that the 22) More than 4 -per outlet (each) .50
Information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Signature of Owner /Agent Date 'SUBTOTAL car,
- 4 ficiTUYI .6rL\44titel L4 \\C-\--/ 5% SURCHARGE
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL 1 '
:, ?:0 '. TOTAL .L., - , t- -
is dst\mechpmtdoc "Minimum permit fee is 325 + 5% surcharge
Rev 7/96
J
RECEIVED
•
JUN 2 3 1997.
• COMMUNITY DEVELOPMENT
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CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: eq A.M. 17 P.M. MST:
Location: l d V ( /f l ) J BUP:
Tenant: Suite: Bldg: MEC: -Qa6 9
Contractor: _ 1.. /i 1 / . ,,U, Phone: .D-g3 r 5 i 4 9 3 PLM:
Owner: I Phone: ELC:
ELR:
2
IT:
BUILDING BLDG (con't) PLUMBING u ay __ •1 r • N • CAL ) SITE
Site Post/Beam Post/Beam .: Cal: Coy - - - • - Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace • Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved - Approved rov Approved
Appr /Sdwlk Not Approved Not Approved Not ..roved Not A. . roved Not Approved
FINAL FINAL FIN • INAL FINAL
/ 0 6 / 6 6 7*-4‘46 k
Lg /
O Call for rein ti O Reinspection fee of $ required before next inspection CI Unable to inspect
Inspector: Date: 6/.z / C Page of
. -.CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -417
�,. I p !JP' BUP
•
/: //1 Date Requested . AM PM BLD
Location Suite ar � J7 - e )- ?
Contact Person Ph &/,.34620 .PL - t�D9�
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: G A ms/t G Q SGN
Slab Q � SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath/Shear C ,
Framing a ��'/°_ �' CjIJv • . -C/
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS P RT FAIL
PLUMB[
Post & Beam
( 1 / 2/ , ; %. ? 9".'
Under Slab �r
Top Out Q
Water Service 1—
Sanitary Sewer
Rain Drains
Fina
i - • RT FAIL
MECHANICAL) -
Post & Beam I
Rough In Il v
Gas Line f
Smoke Dampers
YIP
S 'ART FAIL •
CTRICAL
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
�� Inspector Approach /Sidewalk
Date !/ nspecor \/ (--- L� 1
Other E x t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.