Permit r
CITY OF TIGARD MECHANICAL PERMIT
l". DEVELOPMENT SERVICES PERMIT #: MEC1999 -00540
A � 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED: 12/08/1999
PARCEL: 1 S134AB -03300
SITE ADDRESS: 10330 SW SCHOLLS FERRY RD
SUBDIVISION: ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: 1 COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: • 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 1 <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 2
Remarks: Mechanical TI - furnace, air conditioner, and gas piping
Owner: FEES
MUSLIM EDUCATION TRUST ISLAMIC Type By Date Amount Receipt
PO PORTLAND, BOX 283
OR 97207 PRMT BON 12/08/19c $50.00 99- 320257
5PCT BON 12/08/19c $4.00 99- 320257
Total $54.00
Phone:
Contractor:
CLASS "A" HEATING + COOLING
(DOUGLAS STOKES)
27550 SE HWY 212 REQUIRED INSPECTIONS
BORING, OR 97009
Gas Line Insp
Phone: Mechanical Insp
Reg #: LIC 046039 Final Inspection
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 of these rules or direct questions to OUNC by
calling (503)2 189.
Issue By: ,alQAA Permittee Signature: ,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the nex. usiness day
Plan Check #
CITY OF TIGARD Mechanical Permit Application / By
1312& SW HALL BLVD. Commercial and Residential %� Date Recd - �i
TIGARD, Uv ,'// ' IGARD, OR 97223 �V Date to P.E.
(503) 639 -4171, x304 0 �6ate to DST
_ 2t,', ol-k Print or Type 1 A Permit # (AFL 1��1 W
t(,Cr 1uvNTvR 1 Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
S treet Address Sue# A) Permit Fee r =° 16.00
Job 1) Furnace to 100,000 BTU
' Madress \,( , 33cTh Sw s e\-14:No 'rye %
including ducts & vents 9.65
Bldg# Crty /State Zip
2) Furnace 100,000 BTU+
C�FasprDc �' � including ducts & vents V 12.00 \as t
Name (or name of business) 3) Floor Furnace
Owner c JA l`nc1 including vent 9.65
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater 9.65
5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: 'Boiler Heat Air
. k.AS _ ----\ For items 6 -10, see I or Pump Cond Qty Price Amt
Name (or name of business) . footnotes 1,2 Comp
6) Repair units
Vitiff Occupant Mailing Address 8.40
OccU
P 7) <3HP;absorb unit to
100K BTU > k 9.65 a LII._,
City /State Zip I 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
C.\ .tz... - \ ‘4,..e. : 1,.L 10) 30 -50 HP, absorb
Prior to permit Mailing Address unit 1 -1.75 mil BTU 36.00
issuance, a copy '' C) S� -- \a 11) >50HP; absorb unit >1.75 mil BTU
of all licenses City/State Zip one 60.15
are required if R--p% ∎may .C:) pOc\ CQ( '1‘1y 12) Air handling unit to 10,000 CFM
expired in COT Oregon Const Cor,t?Board Lic # Exp Date 7.00
database ( a - S. \O 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 el No 0 18) Domestic incinerators
Residential 0 Commercial 0 Modification 0 12.00
19) Commercial or industriai type incinerator
A. • itional information or description of work: , 48.25
/�CIC,/ F _ rn a C„(_ i 0, v u p ot// t('ron 20) Other units, including wood stoves
7.00
NOTE: For C mmercial projects only; Units over 400 lbs., located on the 21) Gas piping one to four outlets
roof, require structural caics. prepared by licensed engineer. a 3.75 "1. ..SJ\
Type of fuel: oil 0 natural gas 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 ' g " . , 4,5-0 given is correct, that I am the owner or authorized agent of 8 /o SURCHARGES a� 1 -PO PO
PLAN REVIEW 25% OF SUBTOTAL ''~
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only . . i
Signature of Owner /Agent Date . TOTAL . 54 .0
' Other Inspections and Fees: - .
Contact Pe n Name Phone
1 Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
-" _ "C-x .-- S L.Al. 0 s ---- \ ‘ 2 Inspections for which no fee is specifically indicated (minimum charge -half hour)
$50
Foonotes for commercial projects only: 3 Additional al plan 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 NC 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
/c) ( BUP
Date Requested ted 1 �1 / AM PM BLD
Location L9 330 .5-1) 3 -0(L re-ffi f 2G2— Suite MEC f e i 9-01
Contact Person ChtSS 4 _ 14CttAcl / d(TZA Ph 44 3:7 X0 PLM
Contractor ( `'" Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing ACC- •
Foundation / FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
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 FAIL
MECHANICAL
oP st&beam ,
Rou
as Line rr
mo e Dampers
Fin
A 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
Approach/Sidewalk
14 k
Other Date Inspector Ex
Final
PASS PART FAIL . DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested 01/0 AM PM BLD
Location 1 0 330 Soh S 49^JkAtuite MEC I rf 9 -ciS -1 0
Contact Person Ph dir 1 - C° y 3
Contractor Ph SWR
BUILDING Tenant/Owner �. u ,1 1-- till L.{,1.,\) ELC
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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling , ) / . / _
Roof
T dr •
Misc: /
411, .
Final
PASS PART FAIL r," , ,i
re)
Post & Beam /
Under Slab \ 1
Top Out VVV"'
Water Service
Sanitary Sewe g ' /2
Rain Drai
41M.
= S PART IL
IVECHANI
Post & Beam,'
,• '✓ ,.
Rough In \ 1 // ,��, . %.
Gas Line �"''�s
Smoke ? . . - r
A •• PART
ill ECTRICAL
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 •
Other Date Inspector hThzey Ext
Final
PASS PART FAIL DO NO 'REMOVE this finspectiora r o rd from the job site.