Permit CITY TIGARD MECHANICAL PERMIT
�w DEVELOPMENT SERVICES PERMIT #: MEC1999 -00506
-�� II 13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11 /22/1999
PARCEL: 2S112CA-05300
SITE ADDRESS: 15409 SW THURSTON LN
SUBDIVISION: ASHFORD OAKS ZONING: R -7
BLOCK: LOT: 007 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installing gas fireplace insert and gas piping
Owner: FEES
SANDRA WILLIS Type By Date Amount Receipt
15409 SW THURSTON PRMT BON 11/22/19c. $50.00 99- 319957
TIGARD, OR 97224 5PCT BON 11/22/19c $4.00 99- 319957
Total $54.00
Phone: 603 - 624 -9839
Contractor:
T + K MECHANICAL
TIMOTHY S WYNNE
11525 SW CANYON REQUIRED INSPECTIONS
BEAVERTON, OR 97005
Gas Line Insp
Phone: 626 -4652 Misc. Inspection
Reg #: LIC 00121165 Final Inspection
ORGINA'
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 obO, copies o these rules or direct questions to OUNC by calli 503)246 -9189.
Issue By: I \ Permittee Signature: _
Call (503) 639 -4175 by 7:00 P.M. for inspections nee a next b• iness day
Plan Che #
CITY OF TIGARD Mechanical Permit Application Rec'd By
1315 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # 'M t 7 OCe
I or illegible applications will not be accepted Called
Name of Development/Project Description .
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 16.00
Address I ryoq s' - r -1z t io n 1) Furnace to 100,000 BTU
Bldg# City /State Zip q including ducts & vents 9.65
(t g or / 7 Z . Z7 2) including ducts & vents 12.00
Name (or name of business) ' 3) Floor Furnace
Owner 50.nol 14 /i 1I i 5 including vent 9.65
Mailing Address 4) Suspended heater, wall heater
15 „ 72/1A- r S T O Vent floor mounted heater 9.65
S 5) Vent not included in appliance permit 4.75
City/State /� Zip Phone Check all that apply: *Boiler Heat Air
7 �,,�( A r 1 7 2 v-� (o tce- / a For Items 6 -10, see or Pump Cond Qty Price Amt
NartSe (or name of business) footnotes 1,2 Comp
S� 6) Repair units
8.40
Occupant Mailing Address 7) <3HP;absorb unit to
100K BTU 9.65
City /State Zip Phone 8) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
Contractor Name 9) 15 -30 HP; absorb ,
unit .5 -1 mil BTU 24.15
T
( i ik 1'4 £ c11, `c- - (. 10) 30 -50 HP; absorb
Prior to permit Mailing Address , / 3 unit 1 -1.75 mil BTU 36.00
issuance, a copy 2,05 5 S L. i 1 if�Y 3 40 11) >50HP; absorb unit >1.75 mil BTU
of all licenses City/State Zip Phone 60.15
�
are required if 4 LDLI/ c.,,- et 7OC 35 ? - 9449 12) Air handling unit to 10,000 CFM
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 7.00
database / Z / / to _ 13) Air handling unit 10,000 CFM+
Architect Name 11.85
14) Non - portable evaporate cooler
or Mailing Address • 7.00
15) Vent fan connected to a single duct
4.75
Engineer City/State Zip - Phone 16) Ventilation system not included in
appliance permit 7.00
Describe work to be done: 2' 1 1 '7 94 5 t /Z /,, 17) Hood served by mechanical exhaust 7.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 N 18) Domestic incinerators
Residential Commercial 0 Modifcatiorri 12.00
19) Commercial or industrial type incinerator
Additional information or description of work: 48.25
20) Other units, including wood stoves
6 '1JS ' I 7.00
NOTE: For Commercial projects only; Units over 400 lbs., located on the 21) Gas piping one to four outlets
roof, require structural calks. prepared by licensed engineer. 3.75
Type of fuel: oil 0 natural garb LPG 0 electric 0 22) More than 4 -per outlet (each) .75
I hereby acknowledge that I have read this application, that the information Minimum Permit Fee $50.00 o SUBTOTAL � 4 .(�%
given is correct, that I am the owner or authorized agent of 8 /o SURCHARGE •W
PLAN REVIEW 25% OF SUBTOTAL
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
Signature of Owner /Agent ,,�' Date TOTAL I c11-66
i ( /( - Z Z - t T. Other Inspections and Fees:
tact Person Narpe > Phone
1. Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
r e „, (.../},A „ t 3 S - y 6 (Y 2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
projects only:
$50.00perhour
al
Foonotes for commercial plan
p j y' 3. Additional plan review required by changes, additions or revisions to plans (minimum
1. Provide full schematic of existing and proposed gas line and pressure. charge - one - half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
units. "Residential A/C requires site plan showing placement of unit
•
I:tmechperm.doc rev 11/1/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested %/ /0 AM ✓ PM BLD
Location IS 77,60, e y, eQyj Suite MEC / 9 qq ?)cis - oc,
Contact Person Ph 7,57 6/11 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall r ELR •
Footing Access:
Foundation / FPS
Ftg Drain I SGN
Crawl Drain Inspectio r ' otes:
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Damp rs
F'
AS PART 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
Approach /Sidewalk 12 /64 7 ���
Other Date I l l / Inspector i74 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.