Permit A CITY OF TIGARD MECHANICAL PERMIT
�sr DEVELOPMENT SERVICES • PERMIT#: MEC2000 -00491
"`�" `� I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/18/00
PARCEL: 2S 110BD -00500
SITE ADDRESS: 11790 SW WILDWOOD ST
SUBDIVISION: SHADOW HILLS . ZONING: R -2
BLOCK: LOT: 003 JURISDICTION: TIG
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:
LPG 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of gas furnace.
Owner: FEES
CYNTHIA WERNER Type By Date Amount Receipt
11790 SW WILDWOOD 5PCT CTR 12/18/00 $5.80 2720000000
TIGARD, OR 97224 PRMT CTR 12/18/00 $72.20 2720000000
Phone: 503-624-7946 Total $78.00
Contractor:
AAA HEATING + COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 284 -2173 Final Inspection
Reg #: LIC 00000222
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 (50 )2' • 9189.
Issue ; / ",•_,„ Permittee Signature: F ,,, � _, r rb,.",
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the ne business day
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By M .,_!�
13125 SW HALL BLVD. Commercial and Residential Date Rec'd 'P
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type s Permit # NE-0.9 - 0+0`/9/
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
-QAPC --yria Table 1A Mechanical Code Qty Price Amt
Job Street Address - Suite# A) Permit Fee um ilim 16.00
Address 1) Furnace to 100,000 BTU (12 S'
Bldg# City/State Zip including ducts & vents see footnote 1,2 ` 9.65 �'I
2) Furnace 100,000 BTU+
including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace -
Owner C� r c\Xi .�lo I
_ --, j _ ° , l N�� including vent see footnote 1,2 9
Maili ddress �JCJ 1�4) Suspended heater, wall heater
J I O S l.�-�'"`C or floor mounted heater see footnote 1,2 9.65
5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: `Boiler Heat Air
--1-; n (-7 Vd.3 y t o U./ -7 For items 6 -10, see or Pump Cond Qty Price Amt
Name r name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU 9.65
Occupant Mailing 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
Contractor Name 9) 30-50 HP; absorb
p unit 1 -1.75 mil BTU 36.00
n�C V- C s is , 10) >50HP; absorb unit
Prior to permit Mailing Address r i >1.75 mil BTU 60.15
issuance, a copy �,, °( / �L rr\ k A i ✓N 11 Air handling unit to 10,000 CFM
of all licenses City/State Zip Phone 7.00
are required if 7 ("y Cif?___, a -01173 12) Air handling unit 10,000 CFM+
expired in COT Ore on Cons. Cont. Board Lic # Exp. Date 11.75
database )() 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct
or Mailing Address 4.75
15) Ventilation system not included in
appliance permit 7.00
Engineer City/State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
/ 12.00
New, Repair 0 Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator
Residential 0 Commercial 0 4 48.25
19) Repair units
Additional information or description of work: 8.40
20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0- 0 electric 0 22) More than 4 -per outlet (eac .75
SD
Minimum Permit Fee $50.00 SUBTOTAL IIIIpli ; .
I hereby acknowledge that I have read this application, that the information °'5P4 SURCHARGE 5
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only J
TOTAL
Signature of Owner /Agent Date
a- \--r-11 Other Inspections and Fees: 8
1. Inspections outside of normal business hours (mininum charge -two 7
e ntact Per 6fi e � Phone hours) $50.00 per hour
-. Inspections for which no fee is specifically indicated (minimum
1 �� *.-N ' Y\ 7 ZtA �� g' y - a ( charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge - one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. *State Contractor Boiler Certification required
ff
**Residential NC requires site plan showing placement of unit
hmechperm.doc rev 02/4/99 `-----ID
;Li
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175. Business Line: .639 -4171
BUP
Date Requested / / — 7 AM PM BLD
Location /1 7,0 5&- W /(c� GvOuoL Suite MEC - ) 4`?
Contact Person Ph 5) Z -2) 73 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
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 PART FAIL
CHANIC
o,t & Beam
Rough In
Gas Line
Smo Dampers
F • ..
AS PART FAIL
• RICAL
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 /
Other oach /Sidewalk Date 81 6 Inspector .' �J!!�i'�� Ext
Final ll!
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.