Permit C ITY OF TIGARD MECHANICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: MEC1999 -00166
III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/19/99
PARCEL: 2S114BB -12500
SITE ADDRESS: 10470 SW TITAN LN
SUBDIVISION: SWANSONS GLEN NO.2 ZONING: R -12
BLOCK: LOT: 066 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:
> 10000 cfm: GAS OUTLETS:
Remarks: Add air conditioning unit to an existing dwelling. A/C units cannot be placed within the requied set back areas.
Owner: FEES
ERIC SCHULTZ Type By Date Amount Receipt
10470 SW TITAN LANE PRMT GEO 4/19/99 $25.00 99- 314640
TIGARD, OR 97224 5PCT GEO 4/19/99 $1.25 99- 314640
Total $26.25
Phone:
Contractor:
SPECIALTY HEATING + FABRICATIO
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: 620 -5643 Final Inspection
Reg #: SUP 2570RET
LIC 006657
•
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 obtai -co %. of - -se rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: 4. / Permittee Signature:
Call ( 639 -4175 by 7:00 P.M. for inspections needed the next business day
a 4 i, Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 I Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # ifF /iqf -co /0
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address T Surte# A) Permit Fee 10.00
Address / S� (i r IN / 1) Furnace to 100,000 BTU
including ducts 8 vents see footnote 1,2 6.00
Bldg# cay/state Zip 2) Furnace 100,000 BTU+
including ducts & vents see footnote 1,2 7.50
Name (or name of busines) 3) Floor Furnace
Owner t✓ R i C SCA u L, ?7-^ including vent see footnote 1,2 6.00
Mailing Address 4) Suspended heater, wall heater
��70 (4) / G or floor mounted heater see footnote 1,2 6.00
("�' �t ha 5) Vent not included in appliance permit
City /State Zip Phone 3.00
'Tigard 0 b e � 1 /474 Check all that apply: *Boiler Heat Air
Na a (or name of business) For items 6 -10, see or Pump Cond Qty Price Amt
footnotes 1,2 Comp ••
O
Occupant Mailing Address 1 b sorb unit to
00K BTU I 6.00
7) 3 -15 HP;absorb unit
Crty /State Zip - Phone 100k to 500k BTU 11.00
8) 15 -30 HP; absorb
unit .5 -1 mil BTU 15.00
Contractor Name /� /h al 30 -50 HP ; absorb
i&Cie iii- /hal t v c unit 1 -1.75 mil BTU 22.50
Prior to permit Mallldg Address t/ or n 10) >50HP; absorb unit
issuance, a copy L S.0 so (c7 a/Icr , St >1.75 mil BTU 37.50
of all licenses /State Zi Phone 11) Air handling unit to 10,000 CFM
are required if I J C c i N o t 4.50
expired in COT ojeggd n , opt. Board Lic.# E pjoa eJ 12) Air handling unit 10,000 CFM+
database (O � / ( - 7.50
Architect Name 13) Non - portable evaporate cooler
4.50
or
Mailing Address 14) Vent fan connected to a single duct
3.00
Engineer cttyistate Zip Phone 15) Ventilation system not included in
9 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 0 No 0 7.50
Residents a Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or des ' ption of work: 19) Repair units
2 }.t )-t /� 4.50
,ICJ [ 20) Wood stove
NOTE: For Commercial projects only; Units over 400 lbs. require 4.50
structural gas calcs. 21) Clothes dryer, etc.
Type of fuel: oil 0 natural gas, LPG 0 electric 0 4.50
22) Other units
I hereby acknowledge that I have read this application, that the information 4.50
given is correct, that I am the owner or authorized agent of 23) Gas piping one to four outlets
the owner, that plans submitted are in compliance with Oregon State laws. See footnote 1 2.00
24) More than 4 -per outlet (each)
Signature of Owner /Agent Date .50
nie _e� ivii-P0 4,Z0 Minimum Permit Fee $25.00 SUBTOTAL a. -% 5
Contact Person Name Phone
S t t) L.. i�- - tiezic- /p .7.1) - 5t' 5 /o SURCHARGE • , "3 e;?, z _.
PLA REVIEW 25% OF SUBTOTAL .�.�;;;'
Foonotes for commercial projects only: Required for ALL commercial permits only . =`' s <¢1Y=
1. Provide full schematic of existing and proposed gas line and pressure. TOTAL ":;;"
2. Provide drawings to scale showing existing and proposed mechanical � ; =�; :; yt aZ
units. "'State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
l:4nechperm.doc rev 02/4/99
.N7 ;ice MS oL--1
N
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
c- q
BUP
Date Requested /� 2iS -� / AM PM BLD LD
Location 00470 _ Suite 2 MEC /9l7 - 9C /G,
Contact Person �� �-�Y) �,QAP (Q7Jy (D 1 1j PLM
Contractor Ph SVVR
BUILDING Tenant/Owner ELC I q9 — GozS3
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing ca_ / 9 a
9 - 6 // 6 - 17"M 1'
Firewall
Fire Sprinkler
Fire Alarm /9 q 9 �3 T
Susp'd Ceiling /9
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CMECHAWCAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
3S' PART FAIL A�
Service
Rough In
UG /Slab
Low Voltage
Fire larm
• S PART FAIL
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 - Z �- fY Inspector Ext
Other Dat t Et
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.