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9520 SW BRENTWOOD PLACE
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CITY O F TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2000-00268
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4'171 DATE ISSUED: 07/03/2000
PARCEL: 2S1 1 1CD-04300
SITE ADDRESS: 09520 SW BRENTWOOD PL
SUBDIVISION: SUMMERFIELD 1140.9 ZONING: R-7
BLOCK: LOT: 502 JURISDICTION: TIG
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP- COFAML. INCIN:
MAX INPUT: 96.000 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAM!-ERS T: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + Hr': CLO DRYERS:
FURN 100K BTU: 1 AIR HANDLING UN,;T*S _ OTHER UNITS:
;7'-'RN —100K BTU: <= 10000 cfm: i GAS OUTLETS:
> 10000 cfm:
Remarks: Replace Furnace to 100,000 Btu
Owner: _ FEES _
BIRNEY, MAUD M TRUSTEE Type By Date Amount Receipt
9520 SW BRENTWOOD PL PRMT DST 07/03/2.0( $50.00 0003434
TIGARD, OR 97224 5PCT DST 07/03/20( $4.00 0003434
Phone:620-8745 Total $54.00-
Contractor: OWGINAL COLUMBIA HEATING + COOLING INC
PO BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Mechanical Insp
Phone:624-2704 Final Inspe;tion
Reg #:LIC 00076359
PLM 34-175
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. A" 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 qilestions to OUNC by calling (503)246-9189.
Issue By: _C - C �, t/ Fermittee Signature:
Call (50 639-4175 by 7:00 P.M. for inspections needed the next business day
CITY OF TIGARD Mechanical Permit Application Plan Check#
pl' Rec'd By LG7; 1
13125 SW HALL BLVD. RECEIVEDommercial and Residential Date Rer'd l-3-r91)
TIGARD, OR 97223 Date to P.E.
(50) 639-4171, x304 Date to DST
200
Print or Type Permit# Jld e L Zow 08,?t4
IncgNpi in oeptMhokille applications will not be accepted Called
Name of Developmt/Pro' Description `
'100(7 1 i f Table to Mechanical Code - Qt Price Amt
Street Address A Permit Fee _
Job r 1 sunea 16.00
Address y,2 ;,� f�'�/)!� v( 1) Furnace to 100,000 BTU
including ducts&vents see footnote 1,2 9.65 h
BldgaYIry/state zip_ 2) Furnace 100,000 BTU+
//c' /-GI ��- including ducts_&vents see footnote 1,2 12.00
Name(or name of busines )l 3) Floor Furnace
Owner ) lo, , r o PkI including vent see footnote 1,2 _ 9.55
Mailing Address - 4) Suspended heater,wall heater
or floor mounted heater see footnote 1,2 9.65 _
tv 5) Vent not ncluded in appliance ermit 4.75
City�SLle )
Zip Phone �l)a - Check all that apply: 'Boiler Heat Air
L /1 o) �y, For Items 6-10,see or Pump Cond City Price Amt
Na (or nems of business) footnotes 1,2 Com
6)<3HP;absorb unit to -
O,c_rnant Mailing Address -- 100K BTU 9.65
7)3-15 HP;a.,GorL unit
t 00k to 500k 61 U 17.65
cnyistate zip Phone 8)15-30 HP;absorb
-�� unit.5-1 mil BTU 24,15
N
C mtractor 9)30-50 HP;absorb
f unit 1.1.75 mil BTU _ 36.00
7)LO )1 hie(- 1 (ek I IN 10)>50HP;absorb unit
Prior to permit ning sa >1.75 mil BTU
Is 'e''ce,a copy � .3C)39 7 11 Air handling unit to 10,000^^1", _ 60 15
„
of all licenses C tate Zip Phone 5[)J 7.00
are required if j"61,14 _ i,2 9(--Q Gtr 12)Air handling unit 10,000 CFM+ -
expired in COT Oreg6n Const Cont Board t.k 0 EDate r
database ��.1�� cr 0,') �� -po_ 11.7 _
__ 13)Non- rtable evaporate cooler
Architect Name 7.00 _
14)Vent fan connected to a single duct
or Malling Address �v __ 4.75
15)Ventilation system not included in I'
En
appliance permit 7.00
(neer city/state zip Phone
9 16)Hood served by mechanical exhaust
7.00
Degc rise work to be done 17)Domestic Incinerators
12.00
New O Repair O Replace with like kind: Yes X Nn n 18)Commercial or industrial type incinerator
Residential C-) Commercial O _ _ 48.25
19)Repair units
Additional Information or description of work: 8.40
He$))0 C v 7 4,CCC 6T L 1 0a rf I(tC a- 20)Wood stove/gas FP/other units/clothe dryer/eta
7.00
NOTE: For Commercial projects only;Units over 400 lbs require 21)Gas piping one to four outlets
structural gas talcs _ See footnote 1 _ x.75
Type of fuel oil O natural gas O LPG 0 electric O 22)More than 4-per outlet(eat- 75
_ __ _
Minimum Penult Fee$50.00 __SUBTOTAL ct
I hereby acknowledge that I have read this application,that the information /o SURCHARGEy L1(;
given is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF;iUBTOTAL
the owner,that plans submitted are in compliance with Oregon State laws. Required for ALL commercial pannits onI _
TOTAL
P, er/Agent p Date
Other Inspections and Fees:
1. Inspections outside of norma business hours(mininum charge-two
-o on Nam6 Phone �[ hours per► 550.00 r hour
2. Inspections for which no fee Is specifically Indlc�ted (minimum
)�tl l� /1 ���f �_ ��'��!� charge-half hour) $50.00 per hour
Footnotes 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(ntlnlmum charge-one-half hour)$60.00 per hour
2. Provide drawings to scale showing existing and proposed rrtechanical
units. *State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
lamechpenn doc rev 02/4/99
CIT OF TIGARD BUILDING INSPECTION DIVISION
24--Hour Inspection Line: 639-4175 Business Line: 639-4171 MST
, / BUP
�Daia Requested �'�ou —AM BLD
_ BLD
Location_g5��- SL(� y,r2dl j�-ed� �� S/uite MEC z2z2c9d-00 Zk
Contact Person �� Ph ll/ y ,v7 7D PLM
Contractor A A Mk Ph _ SWR
BUILDING V Tenant/Owner ELC
Retaining Wall ELR _
Footing Access: –
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN —_
Slab SIT
Post& Beam - --- _
Ext Sheath/Shear
Int Sheath/Shear ----_-- - -
Framing -----
Insulation - _
Drywall Nailingc-
Firewall -------
Fire Sprinkler --
Fire Alarm —-
Susp'd Ceiling
Roof
Misc ----
Final ��---- ----_ --------_ - --------- -----.__.------
PASS PART FAIL ------_-_ __._ -- ----T_. ----- --_..-- -_- _ __-.
PLUMBING
Post& Beam
Under Slab
Top Out -- ------ --- --- -_--___
Water Service
-
Sanitary Sewer -
Rain Drains
Final - -- - -- ---_. -- - -___ ._.-
P PART FAIL.
MEQUAB&AL
Post& Beam
Rough In
Gas Line - - - - -
Smoke Dampers
PASS PART FAIL -`"'---------�_------ -__.___...__
CTRICAL
Service
Rough In _--- ----- -.____ ---.__-_
UG/Slab
Low Voltage `-V-----
Fire Alarm
Final ---------------- - ------- ----
PASS PART FAIL
SITE
Backfill/Grading ---
Sanitary Sewer
Storm Drain [ Reinspection fee of$-_ required before next inspection Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspecticio RE: - -- - [ I Unable to i,ispect _no access
ADA
Approach/Sidewalk,
Other Da1e y-OC> InsVeck'er - _ Ext
Final
PASS PART YFAIL_J DO NOT REMOVE this insp ntlon ,,ecord from the job site.