14465 SW 125TH AVENUE 1
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I:Vc�oords%nitcroflm\tat'gets\building.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
2-4-Hour Inspection Line: 639-4175 Business Phone: 639-4171
Date Requested: ! -_` A.M. _ Mn1 MST: 4
Location: rt , _I��/-��_ BUP:
Tenant: ----�— Suite: Bldg: MEC:-7 7-0:3
Contractor: ;/Su) S Phone: g - 376 8 PLM:
Jwner: _ J L _771hone: - r ELC:
_ _ l L 56 � ) -�-- --
_ I N s P. _W_cD, .-- srr: _
BI)TLDING BLDG(con't) PLUMBING �_ G ECHANICA ELECTRICAL SITE
Site Post/Beam Post/Beam Pos Cover/Service Sewer/Storni
Footing Roof UndFI/Slab o -In Ceiling Water Line,
Slab Framing Top out bine Rough-In TJG Sprinkler
Foundation Insulation Sewer - c C Reconnect Vault
Bsmt Damp Drywall Storm �(?urnace , Temp Service MISC.
Masonry Ceiling Rain Iha,ln C A7Ci- T UG Slab
Shcar/She-ath Fire Spklr/Alm Crawl/Foamd Dr I leu ' Low Volt
Approved Approval rov Approved /Approved
Appr/Sdwlk
Not Approved Not Approved cd Not Approved Not A�provai
FINAL FINAL FINAL FINAL FINAL
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O Call for reinspect C7 Reinspection fee of S required be re next inspection 0 I)noble to inspect
Irtepector - Date: Pagel of -
1� CITY ® F TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hai,Rlvd., Tigard,OR 97223 (503)639.4171 PERMIT MEC97-0 45
DATE ISSUED:
UED: 0099/1 /97
PARCEL: 2SI09AA--01000
SITE ADDRESS. . . : 14465 SW 125TH AVE
SUBDIVISION. . . . : ZONING: R-1
BLOCK. . . . . . . . . . . !OT. . . . . . . . . . . . . . JURISDICTION: TIG
------------------------------------------------------------------------------------
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRF'. . : R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HCO03. . . . . . . : 0
FUEL TYPES------------- 0-3 HP. . . . : 0 DOMES. I NC I N: 0
:GAS 3-15 HP. . . . : 0 COM11L. I NC I N: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS ). . - 30-50 HP. . . . - 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 1.O0K BTU: 1 (= 10000 cfm : 0 GAS OUTLETS. : 1
t`URN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Conversion of oil to gas furnace.
Owner.: ____-.------ ___._.__._____.___.______--------_-_-__._._.___-- FEES ---------------
BEN LARSON type aieol_rrt by date rer_pt
14465 SW 125TH PRMT $ 25. 00 DRA 09/15/97 97-299255
TIGARD OR 97224 SPCT $ 1. 25 DRA 09/15/97 97-299255
Phone #: 639-5641
Contractor: ---•---.-------------------------
SOUTHWEST SHEET METAL
ri•41 5 SW 72'ND
----------------------------------------
$ 26. 25 TOTAL
'(-)RT'LAPID OR 97223
-'hone M: 50, 3-246-6284
Reg ft. . : 000450
- - -- REQUIRED INSPECTIONS --- ---
This permit is issued subject to the regulations contained in the Gas Line Insp —
ligi' d Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Heating Un t Insp
approved plans. This permit will expire if work is not started Mi sc. Inspection
within 189 days of issuance, or if work is suspended for more Final Inspection
CL than 189 days. ATTENTION: Oregon law requires you to follow rules _
cd adopted by the Oregon (ltility Notification Center. These rules are T� _
V) set forth in DAR 952-981-8919 through OAR 952-981-9989. You may
obtain copies of these rules or direct questions to Ol1NC by calling
(593)246-9187.
w
Tss1-re Py : k Permittee Signatrme:
1 4+++f+f+++++++++++++++++++++++++++++++++++++++++-F++++++++++.....+++++++++++++++
Call 639-4175 by 6:00 p. m. for inspections needed the next business day
+++++++++++i-++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++.
Plan Ch C"
CITY OF TIGARD Mechanical Permit Application Recd �_
13125 SW HALL BLVD. Commercial and Residential Date Recd -/1
TYGARD, OR 97223 Date to P.E. ^--
(503) 639-4171, X304 Date to DST ,
Print or Type Permit#t 1i G'i 7
Incomplete or illegible applications will not be accepted Called
Name of DeveiopmenvProted Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street ss/L") Surra A� Permit Fee -0- -0- 10.00
Address
e CtyiCttte Zip 1.) Furnace to 100,000 BTU 6.00 ( 0
including ducts&vents
N (w name of ,nassl 2.) Furnace 100,000 BTU+ 7.50
Owner Lo� io � including ducts&vents
M
Mailing 3) Floor Furnace 6.00
including vent
C at Z Z Phone 4,) Suspended heater,wall heater 6.00
or floor mounted heat)r
N (or name of buaeltbssl 5.) Vent not included in appliance permit 3.00
O=pant Mailing Addre 6) Boiler or comp,heat pump,air cond. 6.00
to 3 HP;absorb unit to 100K BUT- _
CdyrState zto Phare 7.) Bo,ler or comp,heat pump,air Gond. 11.00
3-15 HP;absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp,heat pump,air cond. 15.00
(Prior to Ly v SIl ,et 15-30 HP;absorb und.5-1 mil BTU"
issuance Mailing Address 9) Boiler or comp,heat pump,air Gond. 22.5+ -
applk;afit O J .7 1---, _ 30-50 HP,absorb unit 1-1.75mtl BTU-
must provide all rtri cite Zip Ph .[ 10) Boiler or comp,heat pump,air cond. 37.50 ;
contractor r 71 i L L� >50 HP,absorb unit 1.75 mil BTU"
license on Const.Cant.Board Lir..# Exp Data 11.) Air harviiing unit to 10,000 CFM 4.50
information 4
expired in G
COT COT Business Tax or Metro# EXP Data 12.) Air handling unit 10,000 CFM 7.50
database).
Architect Name 13) Non-portable evaporate cooler 450
or Mailing Address 14) Vent fan connected to a single duct 3.00
Engineer CdylStafa - Lp Pna,e 15.) Ventilation system not included in 4.50
appliance permit _
Descnbe work New O Addition O Alteration O Repair O 16) Hood served by mechanical exhaust 4.50
to be done Residential_0 Non-residential O
Additional Description of work / 17) Domestic incinerators 750
18.) Commercial or industnal type 30.00
Incinerator
Existing use of 19) Repair unds 4.50
building or property,
20) Wood stove 4.50
Proposed use of 21 ) Clothes dryer,etc. 450
building or property �1
22) Other units 450
Type of fuel-oil O natural gases LPG O electric O 23) Gas piping one to four outlets 2 00 ZfYr,
F- I hereby acknowledge that I have read this application,that the 24) More than 4-per outlets(each) 50 "lJ
J information given is correct,that I am the owner or authonzed agent of
the owner,that plans submitted are in compliance with Oregon State QTY SUBTOTAL
laws
Sign ireof Owner/Agent Date 'SUBTOTAL
5%SURCHARGE
ct Person Name Phone PLAN REVIEW 25%CF SUBTOTAL
f
(V C / f A TOTAL
(k3tvriezt.doc (rev Minimum permit fee is S25+5%surcharge
"Residential A/C requires site plan showing placement of unit.