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CITY OF TIG
ARD® MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC1999-00443
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/19/1999
PARCEL: 1 S 134CA-00511
SITE ADDRFSS: 11200 SW 119TH AVE
SUBDIVISION: PANORAMA NO.2 ZONING: R-4.5
BLOCK: LOT: 022 JURISDICTION: TIG
CLASS OF WORK: ALT FLUOR 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. INCI&
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
F'RE DAMPERS?: 30 - 50 HP: REPAIR UNITS:
WUODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 _ AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm:
GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install new furnace and gas piping to furnace and "B" sent.
Owner: FEES
JAEGER, TERRENCE L Type By Date Amount Receipt
CAROL J PRMT GEO 10/19/19E $50.00 99-319165
TIGARD, ORR 97223
11200 9TH 5PCT GEO 10/19/19 $4.00 99-319165
Phone:
Total $54.00
Contractor:
GEORGE MORLAN PLUMBING + HEATING
12585 SW PACIFIC HWY
(CCB EXPIRES 6/19/2002) _ REQUIRED INSPECTIONS
TIGARD, OR 97223
Gas Line Insp
Phone: Heating Unt Insp
Reg#:LIC 00002734 Misc. Inspection
PLM 26-60P97 Final Inspection
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Stlecialty 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 (503)246-9189.
r �
Issue By: _ � ��ls�'� e<"Tc.%, Permittee Signature:
` Call (803) 639-4175 by 7:00 P.M.for Inspections needed the next business day
OCT-08-1999 14:2AECEIVED
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 OCT 15 19% Date to P.E. _
(503) 639-4171, x304 Date to DST
LO/O-*M "t�' `�I�o'� Print or Type �Permitt'O'l G°l4�f-�R43
Incomplete or illegible applications will not be accepted Called _
Name of Developmenupro)ect Description
Table 1A Mechanical Code ch, Price Amt
Job Street Address Sunea A) Permit Fee ,..r 16.00
^^�� c�---••11 1) Furnace to 100,000 BTU ) n
Address otQt�.JUJ — includingduds 6 vents see footnote 1,2 / 9.65 9•
Braga Caylstate 71p 2) Furnace 100,000 BTU+
?UD includingducts&vents sec footnote 1,2 12.00
Name(tr name or Duslne s) 3) Floor Furnace
Owner w _includino, vent see footnote 11,2 965
4) Suspended heater,wall heater
Mrumq AAdrcf
^�,� V l� or floor mounted heater sre footnote 1,2 9.65
,r4 5) Vent not included in appliance emit 4 75
Cnyr5tMa Zip Phone Check all that apply: 'Boiler Heal Air
Irq For Items 6-10,see or Pump Cond Qty Price Amt
Name(o ams of b.ineu) footnotes 1,2 Com
6)<3HP:absorb unit to
t00K BTU 9.65
Occupant Mainng Aocreas 7)3-15 HP:absorb unit
100k to 500k BTU 17.65
city/sure Zip Phone 8) 15.30 HP:absorb
unit.5-1 mil BTU 24 15
Nnme 9)30-50 HP:absorb
Contractor /�� unit 1-1.75 mll BTU 36.00
`7 eo ! t�� 10)>50HP;absolt,unit
Prior to permitMallen Address >1.75 and BTU 6015
issuance,a copy t� 11 Air handling unit to 10,000 CFM
0f all licenses c ylswezip hone 7,00
are required H cO12)Air handling unit 10,000 CFM+
expired in COT regon c rill.Cont.Boars uc,e EX511 11.85
:lotabase ..7 (.� U � 13)Non-portable evaparate cooler
Architect Name 7,00
14)Vent fan connected to a single dud
or Maaing Address 4,75
15)Ventilation system not included In
appliance permit 7.00
Engineer Cllyrst.t. Zip Phena 16)Hood served by mechanical exhaust
_ 7.00
Describe work to be done. [„ 7 0 'Q�r' 17)Domestic Incinerators
ins
r`�-�,, ru.0 e. 12.00
New O Repair O Replace wAh like kind: Yes O No 0 18)Commercial or industrial type Incinerator
Residentia0116 Commercial 48.25
19)Repair units
Addflionel information ar desenrrtion of work. ,. 8.40
20)Wood stove/gas FP/other units/clothe dryer/etc.
�c�s p i p��y,
4z) �l.l.I'n0.C�+YP 7.00
NOTE: or Commercialprojects Units over 400 lus.require 21)Gas piping one to four outlels / 75
structural as talcs. See footnote 1 / 3.75
Type of fuel: oil O natural g019A LPG 0 electric O 22 More than 4-par outlet(each) ,75
Minimum Permit Fee$50,00 SUBTOTAL 10" id ;!` ALq v
I hereby acknowledge that I have read this application,that the Information %SURCHARGE `P1
ghlen 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 Litate laws. Required for ALL commercial perynits one
TOTAL �/
SlgenaluO"wntriAgent Date 5Other Inspections and Fees:
1. Inspections outside of normal business hours(maninum charge-two
Coon Name Phone hours) $50.00 per hour
— 2. Inspections for which no fee Is specifically Indicated (minlmum
f D S charge-half hour) $50.00 per hour
t"tas r comfinem al projects only: 3. Additional plan review required by changes,addllians or revisions to
1. Provide full schematic of existing and proposed gas One and pressure. plans(minimum charge-one-half hour)$50.00 per hour
2 Provide drawings to scale showing exlsting and proposed mechanical •State Contactor f9oller Certification required
••Residential AIC requires site plan showing placement of unit
I Vnechpertm.doc rev 7/19/99 _
TOTAL P.O1
CITY OF TIGARD (BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 MST — - -
_
____Date Requested - -- EiL�,SUP
AM PM --
y
Location � � � �,:,�
-_ i - ' Suite rAEC:
Contact Person phI ii,yLM
Contractor Ph S _
-- _ WR _
BUILDING Tenant/Owner ELC
Retaining Wall _--
Footing ELR
-----------------
Foundation CC@SS:
Fig Drain FPS —
Crawl Drain Inspection Notes SGN
Slab — -- --
- --- — ---- SIT _
Post& Ream - ------._. ._
Ext Sheath/Shear
Int She,•h/Shear
Framing
Insu m — ----- -- -- -
Drywall Nailing
Firewall
Fire Sprinkler _
Fire Alarm --'- _
Susp'd Ceiling _
Roof -- - _
Misc:
Final
PASS PART FAIL
PLUMBING
Post Beam
Under
Slab
Top Out -------
Water Service
Sanitary Sewer -�—
Rain Drains
Final - -- --- -- -
PASS PART FAIL
EGHANICAL
Post& Heam -
R-sTI to
a -
as me .
S o e Dampers
F"qz� - _
ASS PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL _SITE
Backfill/Grading ----
Sanitary Sewer
Storm Drain ( ]Reinspection fee of$ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line I 1 Please call for reinspection RE _ [ J Unable to Inspect-no access
ADA
Approach/Sidewalk
Other Date Inspector
Ext
Final -- -
PASS PART FAIL DO 1140T REMO:n this Inspection record from the job site.