Permit CITY, ®F TIC AR® MECHANICAL
. , .
� ,, M= �� DEVELOPMENT SERVICES PERMIT #.......: MEC99- 4
i �IPfi PI i DATE ISSUED: 02/05/9' •
--.- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
' PARCEL: 281,14B5-01100
' SITE ADDRESS.. ..g 10185 SW .SERENA WAY .
SUBDIVISION....: PICKS LAND I NG NO. 1 , , , Z.ON I NG : R -4. 5 ' . .
BLOCK...,..„....: LOT... ........ e :010 ' JURISDICTION\I TIt
CLASS OF WORK.. WALT FLOOR FIJRN ' 0 EVtaP COOLERS: 0 .
TYPE' OF 'USE,....: SF- ,, UNIT 'HEATERS..: 0 " VENT FANS; Q .: 0 . •
OCCUPANCY' GRP. a : R3 , , VENTS W/O APPL_: 0 VENT SYSTEMS: 0 .
STORIES ° 0 8OILERS /COMPRESSORS ' HOODS.'......: 0' '
FUEL TYPES_--- _,__-- - - -.__ L. 0 - -3 HP. ,, . : 0' ' - DOMES. INC IN: 0
' :GAS -. , . . 3 -•15 HP....: 0 " - COMML. INCIN: 0. " • '
MAX INPUT: 0 BTU 15730 HP.....: 0 ' : REPA I R ' UNITS: 0 '
FIRE DAMPERS ?..: i.,0 -50 HF'. < .•.: 0 ` . WOODSTOVE.S.. 2 0
GAS PRESSURE...: .50+ . HP.... i 0 ' ' CLO DRYERS..: ' 0 '
NO,. OF 'MI TS------------ . A'IR 'HANDL•ING UNITS OTHER, UNITS.: . 1 .
TURN < LOOK BTU: .0 , <_ '10000 cfm :' 0 . GAS OUTLETS.: 1 . '
'FURN > =100K BTU: 0 >, 1,0000 cfm: 0 _ ,
Remarks: Gas stove and gis piping ., ' ' , .
O wner: - - -• - - -- • • - - -- FEES -------- --- - - - - -- '
- .
FRANK CHINN - type amount by. date _ recpt
10185' SW SERENA WAY PRMT ' S ' 25. 00 B 02/05/99 99-342730..
TIGARD OR '907E24 ' SPCT •>> ' . :x.0.25 B ' 02/05/99 99- --312730•
Phone #k: '
Contract oi ' ----------- _._--- __.___
JOHN 0 BRANCH, F REPLACES & NOR .
JOHN OSCAR BRANCH ' - -- - - - -- - - - -- - - --
PO BOX 23698 � .' 5 26. 25 TOTAL .
TIGARD OR 97281 ' -
Phone #: 620-0255 , '
Reg #..: 003958 • '
. REQUIRED INSPECTIONS -= ' -
This permit is issued subject to the, regulations contained in the ' Gas .Line I n s p __ _
Tigard' Municipal Code, State of Ore. ,Specialty Codes_ and all , other , Mel,. han i cal I n s p . __
,applicable laws. All work will he done in accordance with Final Inspect i.on , _ _
•
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 ,DAR 952 -001 -0010 through OAR 952 -i'•1- 0080., You may ��•�_ __.__; �._ _ ____._._ _�
obtain copies of these rules 'or direct questions to OIJNC by calling _ _ .. _____
(503)246 -3187. , , ' ' ' __ " . •
Issue By: / ," L - � • Per ~mittee Signature :c l Il eiv VtakM
+ }-- h + + + +=h+ h + + + + ++4-1- t- -144 -4 -[--t•-}•+ +44.44 ++ 4.4-+ F F+ F t + + + + +'-L+ +•d- + + + + + +'F+ ++ +-I• -1 -1-4 !°••h- i--4+ +••F••F-F-F++ '
' Call. 639 -4.175 by 7:00 p. m., for inspect ions needed the next . bus'ines':s day
• i...++ +• -± h- h++++++ 4-+++++- 1-- h++++++++++= F +- 1
++++-++ + +
+- h++++±++ + + + + + ++ + + + +4. + ++-h-i-+ ++ + + + + ++
rian %.nntac
CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd Z •
TIGARil, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # MeCcl'-005Yj
Called
Incomplete or illegible applications will not be accepted
Name of • Description
rn c,A V. 0 ,V\ ∎ Y\ kA Table 1A Mechanical Code QTY PRICE AMT
Job Street Address SW SP A) Permit Fee -0- -0- 10.00
Address l () i q..5 Sr) Serer to \M&
Btdgp City /State Zip 1.) Furnace to 100,000 BTU 6.00
T Ti Q (Z including ducts 8 vents
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner t5_61 Q, including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
including vent
Cnyistate Zip Ppone� -A10 4.) Suspended heater, wall heater 6.00
�b or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
_SC,Lm e,
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City /State Zip I Phone 7.) Boiler or comp, heat pump, air cond. . 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor Name r. 8.) Boiler or comp, heat pump, air cond. 15.00
JOkAe't 0 gN(CIX‘CV1 ,r -p y" ��Ck� 15-30 HP; absorb uniL5-1 mil BTU"
Prior to permit Mailing Address ' ( *- I t - 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy p.n. X i( .g 30-50 HP; absorb unit 1- 1.75mi1 BTU"
of all licenses City/State zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if t�C d Q R. o-c S > 50 HP; absorb unit 1.75 mil BTU*" expired in COT orego f6 onst. Corr. Board uc.a cnzg, ! Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database .3g Qom/ Rg
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent tan 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 O Addition O Alteration O Repair O 16.) Hood served by mechanical exhaust 4.50
to be done Residential O Non - residential O
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 n _ _ / 4.50 q so
Type of fuel - oil O natural gas O LPG O electric O 23.) Gas piping one to four outlets /( 2.00 c 0
i
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 submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Signature of Owner/Agent Date •SUBTOTAL 0 /
1 -Z 7_ 9 I 5 %SURCHARGE /
. tact Person Name Phone / PLAN REVIEW 25% OF SUBTOTAL
Jv11k► D - 8ravI C k (0, 0 -OaSS
TOTAL
i:lmechpmt.doc (rev 9 •Minimum permit
"Residential A/C requl owing placement of unit.
ctrY'/076, 25
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
// 068/bate Requested 2 /(o /J�9 AM x PM BLD
Location /6/15 1 4, y{eL Gt/ Suite MEC 99
Contact Person � Ph (o /1V ;_3// 2 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: ✓ // - SGT
Slab `(/ JI�1.(lL�� /./llil 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
.Q CHANICAI
Post & Beam
Rough In
Gas Line
Smoke Dampers
Vt ,SPART 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 �'a
Other Dat ` I Inspector ` \ E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.