Permit CITY OF TIGARD
MECHANICAL PERMIT
4 t 41 1WillA DEVELOPMENT SERVICES PERMIT #: MEC1999-00375
��� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/09/1999
PARCEL: 1S125DD-07200
SITE ADDRESS: 09625 SW VENTURA CT
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 ZONING: R -4.5
BLOCK: LOT: 080 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:
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: Installation of a gas line for gas stove and gas logs.
Owner: FEES
•
CODY, ROBERT F AND JOAN NE Type By Date Amount Receipt
9625 SW VENTURA COURT PRMT GEO 09/09/19c $50.00 99- 318222
TIGARD, OR 97223 5PCT GEO 09/09/19c. $3.50 99- 318222
Total $53.50
Phone:
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
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 • thes- ules or direct questions to OUNC by calling (503)246 -9189.
Issue By: Permittee Signature
Call (503) 9-4175 by 7:00 P.M. for inspections needed the next business day
CITY-OF TIGARD Mechan Permit:Application r' , - ' ' ^'check# .,
R By " - • ,
- 13125 SW HALL BLVD: REC EIVmmercial and Residential • Date Redd -
TIGARD, OR 97223 v`, - - - Date toP,E. ' . • • -
(503) 639-4171, x304 - F 0 9 1 999 Date to DST
•
CoMMUr�. Print or Type .,' ° Pemh7f�? / -� ?r- • . ..�., j .- .; :.{. - ,'Y_ c all e d hi4# ' •.
Incomplete or ille le application will .not be= accepted . • :. , -,:: :: ,. • . _ . `�`a i
- r.
Name of DevelopmerttlPro)eet Description -
- -- Table .1A Mechanical Code Qty Price Amt' M
•
Job Address - Sultef! A) Permit Fee 16.00
Address %r9S VOLA.tkit Vk, 1) Furnace to 100,000 BTU : _ •
induding duds 8 vents ` see footnote 1,2' "' ` 9.65 i - • - .:-
• Bldglr City/State Z ip 2) Furnace 100,000 BTU +. ..
Y I including duds & vents see footnote 1,2 : : •` • 12 :00 • '
Name ( name orb ess) 3) Floor Furnace • •• ' -'..:L Owner Co ` ( Q 0 A - Including vent see footnote 1,2 ' - '' 9.65 - . : s •
4) Suspended heater, wall heater • .' • • ' -• • -
�� Mailing or floor mounted heater see footnote 1,2 '9.6
a`� c V(1.-., 5) Vent not included in a,piiance permit 4:75
. C e ZIP Phone , . _ • ' "
�!� C heck all that apply: 'Boiler Heat Alr ;, ,y ;. � :'. ' ;. � � �; , , • -- . •
j (f tfJ �10.,D.. 9€/t/...1/.3p/ For items 6-10, see or' Pump Coed Obi..., Price : Amt : ' r
(or name of business) footnotes 1,2 Comp
S a . —__ 6) G1HP;absorb unit to
100K BTU ' • V
• Occupant ' Address 7) 3-15 HP;absorb unit - . . - • •
- 100k to 500k BTU • 17.65 '
• ' - City/State Zip Phone 8) 15 -30 HP; absorb . -
unit .5-1 mil BTU ' - • • _ 24:15 v,
' •,. CO Ctor Name 9) 30-50 HP; absorb
p f Q � + /e�f �� ,� ,, i � unit ' -1.75 mil BTU � 36:00 ;• '-',..�
I d - M e- viicJ � �. 10 SOHP; absorb unit • • . ' ' �'�x ;, ;
- • • } ;.
Prior to permit Address 1 >1.75 mil BTU• - ' -- • ' " ,' . - •'60.15: .. •-'
issuance, a copy # Se-4.) toll A 11 Air handling unit to 10,000 CFM
are required if er IA 77 S �+ - ( 4t 9 unit 10,000 C
C61 , 12) Air handling 1FM , +
'`'
expired In COT Oregon Conk. Corn. Board Ue.# Exp. Date -- - - • - ' ' ' ' 11.75
database 13) Non - portable evaporate cooler ' . L. ; , `= r•'
Architect Name
14) Vent fan connected to a single dud • . '. ` - . , '.0',..
or Mailing Address = 4.75' c; -,
• 15) Ventilation system not included in • - .
appliance permit 7.00 ' �
Engineer City/State Zip Phone °
g 16) Hood served by mechanical exhaust' `. - • M • •_
- , :_ r 7.00 ` •. qy ,
• • ? • Describe work to be done: 17) Domestic incinerators - . • 1 �.. .{ -y • • • •, • -, ' <• ,'k
- r .,,, 12.001 ' e.• xt 4.,
• New 0 it ' Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator : „ti ..., '."... ;x •::
TaalO .. - . •• ' 'A8:25.. - - .. '
- 19) Repair units • •,. ' :., .,- -E .
- Additional Info nor description of work•
” . i ` � C C g �-,p 20) Wood stove/gas FP /other units/dothe dryedetc:{ .. - ; ' {: ,• • '.. d� . - �•', 7 .00;,, n
N For Commercial, projects only Units over 400 lbs. require _ 21)'Gas,piping one to four outlets' ' •-•,' •-' r • •`- •;. ' `' 3 y
structural gas talcs. • - ' See footnote 1 ;
Type of fuel: oil O natural gas LPG O electric O 22) More than 4 -per outlet (each) • -,- • .•' • '. •.-, .75 ' : % • ', ..-4 • • - -- _ - _ . _ Minimum Permit Fee 650.00 SUBTOTAL .. _ _ � .4 , 4
• - I hereby acknowledge that I have read this application, that the information • . • 7% SURCHARGE: : _
-_ ,.. ,_ ..g.'•• • : :
• • ' given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL - "` j { = i
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial. permits only - i '- r''- ^` r ° r s
, . TOTAL • •. ..: '
' .=
• Signature of Owner/A nt �`�
! Date r
. • ' ' - Other Inspections and Fees: - 5,
- -- 1.' Inspections outside of normal business hours' (mininum'cliarge -two`'' . •:' '.•:;
• - Contact Person Name. Phone • •
hours) Sti0.00 per hour • :. " , ';. '' ': • �'• ,:." • .,• , � •• : r . .�
. , 2. - InspectIons for which no fee isspeciftcallyIndicated (minimum - ‘',:,4;:•_1,,;J: �
:charge - half hour) 650.00 per hour•. , ::'. :,,` .. a• s;:. �; -:aa;; r
Foonotes for commercial projects only 3: Additional plan review required by changes, additions or `revisions t
1. Provide full schematic of existing and proposed gas line and pressure. ;plans (minimum charge-one -half' hour) 650.00 per hour, ; • • `-, a',
2. Provide mechanical ' -' .
drawings to scale showing existing and proposed
'� • . . .r" - Y . `, -•,, is +,'v'� ; a ���
units.
' - ' . •State Contractor Boiler Certification required • ' • • ' , .. '_ ' .
"Residential NC requires site plan showing placement of unit''• _ ' :' :. ,-
'. ' Iarnechperm.doc rev 02/4/99 r •
- cti
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested q Zq " / q AM PM BLD
Location q&2.? U 1' .. � C Suite MEC 1171-06;
Contact Person f1 olcm)vl Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Ina Sheath /Shear �
Framing ` / �j �, �,�j ,e,C/� O7 /.
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
Post &Beam
Rough In
Gas Line
Sm.. e Dampers
agr
PART FAIL
EL - CTRICAL
Service
Rough In
Low Voltage
b
Low V
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 4o_ Inspector Ext
Final •
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.