11765 SW GAARDE STREET �i
I
11765 SW GAARDE Si'.
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CITY OF TIGARD BUILDING INSPEC ION DIVISiON
24-Hour Insnection Line: 639-4175 Bus' ss Phone: 639 171
Date Requested: 130r- _ ` A.M. — P.M. MST:
1 cx anon: LZ6—,,57 _ BUP:.
Tenrmt: ` Suite: —Bldg:
PLM:
Phone: _
Contractor: - --
0%%iier: _.— ��— Phone: ELC: ..-- --
ELR:
SIT: _
BUILDING BLDG(con't) PLUMBING CHANIC_Aj,,- ELECTRICAL SITE
Site Post/Bcam Post/I;eam Post./Beam Cover/Service Sewer/Storm
F ooting Roof UudFI/Slab Rough-Ln Ceiling Wate• Line
Slab Framing Top out Lias Line Rough-In 11G Sprinkler
Foundation Insulation Sewer IDood/Duct Reconnect 'fault
Bsmt Damp Drywall StormurnacmC,�CC�u.% 'temp Service MISC.
Masonry Ceiling Rain Thain AM- U UG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found IX Heat PkQp Low Volt
Approved Approvedrover., Approved Approvt-d
Appr/Sdwlk Not Approved Not Approved o roved Not Approved Not Approved
FINAL FINAL FINAL, FINAL
VNI 0"
Call for reinspection 0 Reinspection fee of S^_ r uired before next inspection O Unable to inspect
Inspector: CDate: � _� Page_ of-----
CITY OF T'GARD MECHANICAL
PERMIT
DEVELOPMENT SERVICES PERMIT #. . . . . . . : M E C�a 7—0 22 4
13125 SW Hall Blvd., Tigard,OR 97223 (503)639-4171 DATE ISSUED: 07/01/97
PARCEL-: 2SI.03CD-026-00
SI-FE ADDRESS. . . : 117611
SUBDIVISION. . . . - ZONING: R-4. 5
BL-OCK. . . . . . .. . . . . L..OT. . . . . . . . . JURISDICTION: TIG
CLASC'; OF' WORK. . :ALT FLOOR FURN. . . 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. 0 VENT FqNS. . , : Q7?
OCCUPANCY GRP. . :R3 VENTS W/O APPL-: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . 0 BOIL-ERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL- 0-13 HP. . . . 0 DOMES. INCIN: 0
-GAS AS 3-13 HP. . . . COMML— INCIN- 0
MAX INPUT: 0 BTU 15-30 HP. . . . 0 REPAIR UNITS: 0
F I RE DAMPERS?. . : 30-50 HP. . . . 0 WOODSTOVES. . : 0
GAS PRESSURE. . . 50-4- HP. . . . 0 CL.O DRYERS. . -. 0
NO. OF AIR HANDL.ING UNITS OTHER UNITS. : 0
FURN ( 100K PTU: 1. I=- 10000 C-fifl : 0 GAS OUTL-ETS. : I
FURN > ----1.00K STU: 0 > 1.17.1000 c-fim : 0
Remar-ks : Installation of gas furnace.
OWTIEW.- FEES
PHILL. H., C SPENCER type amol-int by date r-erpt
11765 SW GAARDE ST PIRMT $ 25. 00 DRA 07/01/97 97-296647
TIGARD OR 9721214-2808 5FIC T 1. 25 DRA 0*7/01/9-t 97-29664-7
Phone #- 639-0121
Contr,Ar-tor-:
OWNER
26. 25 TOTAL
Phone #:
Peg #. . : 000131.
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Nunicipal Cnde. State of Ore. Specialty Codes and all other Mec-hanical. Insp
applicable laws. All work will be done in accordance with Heating Unt Insp
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work ii suspended for more
than IN days. ATTENTIDN: Oregon law requires you to follow rules
adapted by the Oregon Utility Notification Centel ose rules are
set forth in OAR 952 001-00L0 through OAR 952-001-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
P(-rmittea Si gnat i-tt-e
*+++++++++4...4•..................4...........4 ..............................4.+++4
Call. 639-4175 by F,:00 p. m. for- insper-tions needed the np,<t bl.ksiness day
4•............V+4.................4•.........4.......... •++++++++++++++++
Plan Check q
CITY of TIGARD Mechanica,' Permit Application Rar;*d 8y
13125 SW HALL BLVD. Commercial and Residential Data Recd
TIGARD, '3R S' '23 Date to P E. -
(503) 639-4171, x304 Date to DST
Print or Type Permit 0 Ji--fs c�i I-,!
Incomplete or illegible applications will not be accepted Called -
Name of Deve(opment/Protect Delcr.ption
Table 1A Mechanical Code OTY PRICE AMT
,lob street Address SuneN y A) Permit Fee -0- -0- 1000
Address
Ridge Cnyistate zip 1.) Furnace to 100.000 BTU 6.00
including ducts&vents
Name tornameof business) 2.) Furnace 100,000 BTU+ 7 50
owner including duds&vena
Mailing Address 3.) Floor Furnace _L 6.00
r.•.; ��� �' including tent
cnyrswq 21p Phone 4) Suspended heater,Yrall heater
_ f or floor mounted heater
Name for name of businesal 5) Vent not included in appliance permit 3.00
4-
Occupant
Occupant Mailing Address — 6) Boder or comp,heat pump,air Gond. 6.00
_to 3 HP;absorb unit to 100K BUT"
i;ty,3iate v Zip Priono 7.) Boiler or comp,heat pump,air Gond. 11.00
_ 3-15 HP;absorb unit to 500K BTU" _
Contractor Naine 8) Boiler or comp,heat pump,air Gond 15 00
(Pnor to _ 15-30 NP;absorb und.5 1 and BTU"
issuance Mailing Address � 9) Boder or comp,heat pump,air Bond _22.50
applicant 30-50 HP;absorb unit 1-1.75mil BTI1"
must provide all cityitne Zip Phone 10) Boiler or camp,heat pump,air Gond 3756—
contractor
750contractor _ >50 HP;absorb unit 1.75 mil BTU" _
license Oregon Const Cont Board Lic a Exp Date 11 ) Air handling unit to 10,000 CFM f 4.50
information _ _
for COT COT Business Ta,or Mew a Exp Data 12) Au ha filing unit 10,000 CFM 7.50
database)-_ _
Architect I Nama i 13) Non-portable evaporate cooler 4.50 _
or Maiing Address '4) Vent fan connected to a single dud 300
Engineer Crtyrstre — zip Phone 15) Ventilation system riot included in 450
appliai ice pemtd
') scnbe work New O Addition O Alteration 4 Repair J 16) Hood served by mechanical exhaust 4.50
to be done Residential C Non-residential O
Additional Description of work t 7) Domestic incinerators 7.50
` G r 18.) Commercial or industrial type _ 3000
_ Inune,•alor
Existing use of ~— 19) Repair units 450
building or property— _
20.; Wool stove 4-5O—
Proposed
50Proposed use of 21 ) Clothes dryer,etc 450
building or property -�- --_— __ _ _
22) Other unds� 4 50
Type of fuel oil n natural ge;• LPG O electric O 23.1 Gas piping one to four outlets —2.00
I hereby acknowledge that I have read th s application,that the 241 More than a-per outlets(each) 50
information given is rorect,that I am the owner or authorized agent of
the owner that plans submitted are in c-mpliaoce with Oregon hate iOTY SUBTOTAL
laws
Signature of OwoeilAgent Date 'SUBTOTAL
---- ~5%SURCHARGE
ConLict Person Name Phone PLAN REVIEW 259%OF SUBTOTAL
^----- �— —`e —� TOTAL
i.ldstVnechpmt doc (rev 9 'Mlnnnum perrrrit fees S25+5%surcharge
"Residential A/C requires site plan showing placement of unit.