Permit 6 A CITY OF TIGARD MECHANICAL PERMIT
PYl DEVELOPMENT SERVICE PERMIT #: MEC1999 -00508
AO r'lll 13 125 SW Hall Blvd., Tigard, OR 97223 ( DATE ISSUED: 11/23/1999
PARCEL: 2S103BC -05600
SITE ADDRESS: 12235 SW TIPPITT PL N
SUBDIVISION: TIPPITT PLACE l ZONING: R -4.5
BLOCK: LOT: 006 JURISDICTION: URB
CLASS OF WORK: OTR 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:
WOD 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: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of wood stove.
Owner: FEES
DEPAOLI, PETER JAMES + TONI -AN Type By Date Amount Receipt
918 NE BIRCHAIRE LN • PRM4 DST 11/23/190 $50.00 99- 319983
HILLSBORO, OR 97124 5PC2 DST 11/23/190 $4.00 99- 319983
Total $54.00
Phone:
Contractor:
OWNER
REQUIRED INSPECTIONS
Woodstove lnsp
Phone: Final Inspection
Reg #:
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 -0 10 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
callin (503)246 -9189. / /� _ /\
Issu y: _1 , i, /_'4 j Permittee Signature. 4 i
- Call (503) 9-4175 by 7:00 P.M. for inspections ne d the next business day
CITzit TIGARD Mechanical Permit A lication Plan
pp Recd B By y 1J
13125 SW HALL BLVD. Commercial and Residential Date Rec'd / /'a'?3 Y ip
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 �� Date to DST
Print or Type Permit #f�/�0'f9� e
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description .
Table 1A Mechanical Code Qty Price Amt
Street Address / g ep A) Permit Fee 16.00
Job
Addre /Pi� ✓C �/,8 1) Furnace to 100,000 BTU :_1
Bldg# City/State Zip including ducts & vents 9.65
2) Furnace 100,000 BTU+
including ducts & vents 12.00
(or name of busines 3) Floor Furnace •
Owner �C.4 --- r including vent 9.65
Mailing Address 4) Suspended heater, wall heater
/ Z z 3 .S J 77
�' t- 77 f I + - L or floor mounted heater 9.65
5) Vent not included in appliance permit 4.75
City /slate Zip Phone_ Check all that apply: *Boiler Heat Air
77 9 72 2 3 -S - Wo For items 6 -10, see or Pump Cond Qty Price Amt
Na�fe (or name of business) . footnotes 1,2 Comp
£ , 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
cc 10) 30 -50 HP; absorb
re r /' T YV'
Prior to permit Mailing Add c ,,, y t�C unit 1 -1.75 mil BTU 36.00
issuance, a copy (✓ Y''J 11) >50HP; absorb unit >1.75 mil BTU
of all licenses City/State Zip Phone 60.15
are required if 12) Air handling unit to 10,000 CFM
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 7.00
database 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: 17) Hood served by mechanical exhaust
7.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Domestic incinerators
Residential C9 Commercial 0 Modification 09-' /7 12.00
19) Commercial or industrial type incinerator
Additional information or descript' n of work: 48.25
/,,5' L° a ,j gi/�L i..� 20) Other au i nits/ip stoves
G' D / 7.00 7
NOTE: For Commercial projects only; Units o ver 400 lbs., located on the 21) Gas piping one to four outlets
roof, require structural calcs. prepared by licensed engineer. 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 22) More than 4 -per outlet (each) .75 eV
I hereby acknowledge that I have read this applica at the information Minimum Permit Fee $50.00 o SUBTOTAL ,,_0 given is correct, that I am the owner or authorized agent of 8 /o SURCHARGE 54
PLAN REVIEW 25% OF SUBTOTAL
the owner that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
r re of • • -r /Ag: Date TOTAL 1111111 5 4/. e.. " 0
p
J / �2� / Other Inspections and Fees:
' Contact Person Name Phon
- 1. Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
C / l l 7 , C�J��( / � v ' 7 _ �Z 2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
Foonotes for commercial projects only:
$5o
3. Additional o onaal l pour
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:\mechperm.doc rev 11/1/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 • Business Line: 639 -4171
/ I Q- BUP b 1
Date Requested l q I q AM PM `- BLD
Location / ?--013-5-- 5 1 1I [ T� � p p(+ ( Suite MEC / 47 q 9-6115-) k
Contact Person P-de-,� k� pay) (t Ph c” F� g'�` PLM
Contractor Ph to SWR
BUILDING Tenant/Owner ���'l�� ‘.)-qg &L- ELC
Retaining Wall ELR
Footing Access: (, 61 - �i� FPS
Foundation
Ftg Drain !0 A / PN/
Slab
Crawl Drain Irlsp= ti og �A SGN
Post & Beam Q( C> SIT
Ext Sheath /Shear /9"
We( (h (4- s/j(z-./
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
P PART FAIL
Post & Beam
Rough In
Gas Line
Smoke Dampers
' • PART FAIL
ELECTRICAL
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
Otheoach /Sidewalk Date / Inspector ' � 7 4 Ext,�
Final -
PASS PART FAIL D + NOT REMOVE this inspection record from the job site.