Permit CITY OF T MECHAN I CAL
m1 DEVELOPMENT SERVICES PERMIT
� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # • MEC98 -0469
DATE ISSUED: 10/21/98
0j PARCEL: 25102CA -00932
SITE ADDRESS...: 13350 SW VILLAGE GLENN DR w++
SUBDIVISION : VILLAGE GLENN � � ZONING: R -4.5
BLOCK • LOT . •032 ® 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
:GAS 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 : Installation of gas furnace & piping.
Owner: FEES
PEGASUS WOODRIGHTS type amount by date recpt
4130 SW 117TH AVE PRMT $ 25.00 DLH 10/21/98 98- 310178
PORTLAND OR 97005 SPCT $ 1.25 DLH 10/21/98 98- 310178
Phone #:
Contractor:
GEORGE MORLAN PLUMBING
5529 SE FOSTER
(CCB EXP 6/2002) $ 26.25 TOTAL
PORTLAND OR 97206
Phone #: 771 -1145
Reg C. 000027
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 Mechanical 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 -001 -0010 through OAR 952-001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246-9187.
Issue By: /e1 Permit tee Signature: frig/L- 4/ /MP 69
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + ++ + + + + + + + + + + + + + + ++ + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
•
RECEIVED P.01 414-1440.
,,. .,.. ;... �erV..r ralulydl rrt initMNNIll:i3itOn i '1 : cdey Lff
13125 SW HALL BLVD.
Om 2 -. 199�Eommercial and Residential ®` Date Raced
OE T IGARD, OR 97223 Date to P.E.
(503) 639 -4171, X304 C0nWTl.) _c464. _l 3 13' Date to DST
Print or Type z Permit # /Yre 9P -o 9
Incomplete or illegible applications will not be accepted Called
Name of oevelepnenUProrea Description
Table 1A Mechanical Code Qty Price Amt
Job SIMI A°aress Wee A) Permit Fee anlariM 10.00
1) Fumeoe to 100,000 BTU l r�rar'
Address /3350 Ili ta'aG 6 16 , 11 including ducts & vents I 6.00 ! ('`Y'
BIdga Ceyrsmle LP 2) Furnace 100,000 BTU+
- T'&i 1 0( q -2) Including duds & vents •,,. 7.50 ,
Name far name a business) 3) Floor Furnace
Owner P SV6 V DIDR 161 l 15 including vent 6.00
f�eu�nQpeeross 4) Suspended heater, wall heater
130 5 I' AVE _ or floor mounted heater _ 6.00
�j- J V 8) Vent not included in appliance permit
C*ylState Lp Phone 3.00
- P0 R iAr) 970051515-Y64 r CHECK ALL `Boiler Heat ' Air
Mane to name d bvsaIses) THAT APPLY: or Pump Cond Qty Price Amt
V A GA Nr - Comp ..
H' 6) 4HP;absorb unit to
Occupant lading Addm 100K BTU 6.00
7) 3-15 HP;absorb unit
CIlyrSUre ap Phone 100k to 500k BTU I 11.00
r 8) 1530 HP; absorb
unit .5-1 ml BTU 15.00
COntracttr Nsme 9) 3050 HP; absorb
(1&). fl \r f Z unit 1 -1.75 mil BTU 22.50
Prior to permit Malang �rU: t r 10) >50HP; absorb unit
issuance, a copy (1 a S4 TI le Si- >1.75 mil BTU 37.50
of all licenses c 3wte aliz2.3 ' Phone 11) Air handling unit to 10.000 CFM
are requ if 1 t yi 1 C :124"0 5 4.50
expired d ��� T Z�� 4 • save (kg ��/� � 12) Alr handling unit 10.000 CFM+ 7.50
Arch) N 13) Non portable evaporate cooler
4.50
or
�dree9 14) Vent fan connected to a single duct
I 3.00
15) Ventilation system not Included in
Engineer LP Pharli appliance perrnit , 4.50 -
15) Hood served by mechanical exhaust
Describe work to be done: • • - - 4.50
17) Domestic incinerators ,
' New 0 ' Repair O Replace with like kind: Yes 0 No 0 7.50 , .
• ' Residential • _ Commercial O 18) Commercial or Industrial type incinerator
30.00 -
Additional information or description of work 19) Repair units
4.50 •
20) Wood stove
1 4.50
21) Clothes dryer, etc.
4.50
Type of fuel' oil O natural gas i LPG 0 electric 0 22) Other units
. 4.50
I hereby acknowledge that I have read this application, that the infOnnatlon 23) Gas piping one, to four outlets
given is correct, that I am the owner or authorized agent of I . 200
the owner. that plans submitted are In compliance with Oregon State laws. 24) More than 4-per outlet (each)
.50 '
Slgnatu : of Owner /Agent Date ' ' , .
/ Minimum Permit Fee (25.00 SUBTOTAL
4 tv /9
/ 5% SURCHARGE ,;
Co i.... -t• • n Name Phone PLAN REVIEW 25% OF SUBTOTAL
J e q . S , pea Ke. C.024 '"( Required for AU. commercial . Its • TOTAL .. •.. �, 17
- 1 -State Contractor Boiler Cerdfiation requi red
• Lc -Residential NC requires she plan allowing ptaoemenl of unit
mt.
1:4nedtpedoc rev 0720/98 , v
TOTAL P.01
6/13/00 Activities for Case #: MEC98 -00469
3:21:13 PM k�
Assigned Hold Updated
® 0
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application ■ received 10/21/98 DLH MAIL DLH 10/21/98
MECA008 Create Permit 10/21/98 DLH DONE DLH 10/21/98 .
MECA799 Final Inspection DLH 10/21/98
MECA715 Mechanical lnsp 10/21/98 DLH 10/21/98
MECA705 Gas Line Insp 10/21/98 DLH 10/21/98 ,
MECA060 (F) Issue permit 10/21/98 DLH DONE DLH 10/21/98
MECA880 Expired by limitation 6/12/00 HAP DONE No Hold AKJ 6/12/00
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