Permit r CITY OF T
MECHANICAL
DEVELOPMENT SERVICES PERMIT
/ � 4, d �' M�� ` 1 PERMIT # MEC98 -0197
!+L -'� 1 3125 SW HaII Blvd., Tigard, OR 97223 (503)639-4171
639.4171 DATE ISSUED: 06 / 02 / 98
PARCEL: 25102CA -00935
SITE ADDRESS...: 13410 SW VILLAGE GLENN CT
SUBDIVISION • VILLAGE GLENN ZONING: R -4.5
BLOCK • LOT -035 JURISDICTION: TIG
CLASS OF WORK• °:ALT FLOOR FURN 0 EVAP COOLERS: 0
TYPE OF USE -SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP•.:R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES 0 BOILERS /COMPRESSORS HOODS ° 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
3 -15 HP 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS?..: 30 -50 HP : 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Install new furnace and gas piping.
Owner: FEES
ANDREW CARLISLE type amount by date recpt
13410 SW VILLAGE GLENN CT PRMT $ 25.00 GE0 06/02/98 98-306209
TIGARD OR 97223 SPCT $ 1.25 GEO 06/02/98 98- 306209
Phone #:
Contractor:
ROBBEN & SONS HEATING
2300 SE 7TH AVE
P 0 BOX 14867 $ 26.25 TOTAL
PORTLAND OR 97214
Phone #: 233 -5841
Reg #..: 001884
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Insp
applicable laws. All work will be done in accordance with Final Inspection
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 by the Oregon Utility Notification Center. Those'rules are
set forth in OAR 952 -wi1 -0010 through OAR 952 -001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling -
(503)246 -9187. .
-ANIP501Pr
1 / 1 /
Issue By:// „ ' r t Permittee Signature: _ANEW
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
CITY OF TIARD Mechanical Permit Application : Recd By -
13125_ SW RALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST ,
Print or Type Permit # Afe 40-o/9 7-
Called
Incomplete or illegible applications will not be accepted
Nem9 of DevelopmenUProl Description
Oa-Nag. G Table 1A Mechanical Code QTY PRICE AMT
Job Street Address � a � nea A) Permit Fee • -0- -0- 10.00
Address ,� ,4 /Q / / / / 4 f/
Bldg# City/S 4 Zip 1.) Furnace to 100,000 BTU 6.00
1 ' • / including ducts & vents /.
Name (97ame of busegse ) 2.) Furnace 100,000 BTU+ 7.50
Owner / including ducts & vents
Me c
/3 1) Address -_ / 3.) Floor Furnace 6.00 '
/a �a) dab.ye/ /t4 . including vent
City/S to �ddJ Zip Phone. 4.) Suspended heater, wall heater 6.00
or floor mounted heater •
Name ( name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00 •
to 3 HP; absorb unit to 100K BUT
City /State Zip l Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor 311 4a11,14 Om ) 8.) Boiler or comp, heat pump, air cond. 15.00
15-30 HP; absorb uniLrl mil BTU"
Prior to permit i l in . Add 9 .) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy p " . / � P 30-50 HP; absorb unit 1- 1.75mi1 BTU"
of all licenses C 9- t� � AP/ P� r 17 10.) Boiler or comp, heat pump, air cond. 37.50
are required if ( j z4) . ! > 50 HP; absorb unit 1.75 mil BTU" •
expired in COT Oregon Con�C r Bo Uc.# r � 11.) Air handling unit to 10,000 CFM 4.50
database !
Architect Name 13.) Non - portable evaporate cooler 4.50
•
Or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City /State Zip - Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional Description of work: 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
Proposed use of , 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas 0 LPG 0 electric 0 23.) Gas piping one to four outlets ` 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) / .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans _ •m • -d are in compli- • -- ith Oregon State ' QTY. SUBTOTAL
laws. , .
Signature of •_ er /Age/ - - Date *SUBTOTAL ar AW � 5 % SURCHARGE �
. 25% C o n tact Pe - Name Phone PLAN REVIEW 25 /o OF SUBTOTAL
TOTAL a‘gr
i:\Irtechpmt.doc (rev 9 'Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit. i
CITY OF TIGARD BUILDING INSPECTION DIVISION : MST •
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / AM PM BLD
Location ) 3M I C U (� l �n of- Suite MEC 9 f Oci 77
Contact Person pp ��,, Ph PLM
�U
Contractor 1 . SOhS Ph • .J 3 -S$ %i SWR
BUILDING Tenant/Owner • ELC •
Retaining Wall ELR
Footing • Acce
Foundation �„ FPS
Ftg Drai ��LU 17 � '� l �,
SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam •
Ext Sheath /Shear
Int Sheath /Shear
Framing
Inulati
D on Nailing /a1 /' A , i •
Firewall
Drywall "J � r /Ali J
Fire Sprinkler
Fire Alarm c - � s �'
Susp'd Ceiling �/
Roof
Misc: 94/q Final 7 /4,
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
I CHANIC )
•
Pos &Beam
Rough In
Gas Line
�; Dampers
PART FAIL
TRICAL
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 .-00
4
Approach /Sidewalk
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.