10305 SW HIGHLAND DRIVE-1 N
O
W I
O
Ut
L
E
S
N•
LO
2. ?
F-,
Cl.
d
H
i
I
1
I1
I
�1
4QAxA
T
gr,IHG QNV IHc-)IH MS SCOT
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hoar Inspection Line: 6394175 Business Phone: 0394171
Date Requested: I " .L t " �� P.'vt. MST:
I� -
Location: ��i .��'� s (, ) /� (,,LJ��1 �` - BUP: 1
Tenant:_ _ Suite. Bldg: __-- MEC:�-�c
Contractor: LT Phone: "� PLM:
uwncr: t Phone: "r
_4 �— ELR:
------- SIT:
_ _ SIT: _
BUILDING BLDG(con't) PLUMBING MEC'HANICAALL ELECTRIC%L SITE
Site I'osU13uu11 Post/Beam os cam _--� Cover/Service Sewer/Storm
Footing Roof, UndFVSlab Rough-In Ceiling Water Line
Slab I earning Top Out nes I1ure _` Rough-in IJG Sprinkler
Foundation Insulation Sewer ct Reconnect Vault
Bsmt Damp I)rywail Storm Fmti!'te �� Temp Service MISC.
Masonry Ceilinp; Rain Drain A/C UG Slab
Shcar/Sheath Fire Spi lr/Alm CrawWound IN Heat Pump Low Volt _
Approved Approved ro Approved Approved
Appr/Sdwlk Not Approved Not Approved N roved Not Approved Not Approved
FINAL FINAL INA FINAL FINAL
O Cali for reinspection f3 Reinspeetion fee of Srequired betoic acm inspection 13 Linable to inspect
Inspector _�/ _ Date:�1/ / ..L_/1�'_Z page of ,�_
CITY OF TIGARD MECHANICAL
DEVELOPMENT SERVICESPFRMIT
'FRMIT #. . . . . . . : MEC97-0460
13125 SW Hall Blvd., Tloard,OR 97223 (503)639.4171 DATE ISSUED: 11 /20/97
PARCEL: 2SI11CC--13100
SITE ADDRESS. . . j.0305 SW HIGHI.-AND DR
SUBD I V I S I ON. . . . SUMMERF I ELD 110. 4 ZONING: R-7 PD
Ell OCK. . . . . . . . . . LOT. . . . . . . . . . . . . : 182 JURISDICTION: TIG
C1---OE9 OF WORK—ADD FLOOR FURN. . . . - 0 EVAP COOLERS: 0
TYPE OF USE. . . . 5F UNIT HEATERS— : 0 VENT FANS. . . : 0
OCCUPANCY GRf-",. . R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . Q, BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL... TYRES-------------- 0-3 HP. . . . : 0 DOMES. INCIN: 0
3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 11P. . . . - 0 REPAIR UNITS: 0
FIRE: D9MPE RS 30-50 HP. . . . : 0 WOODSTOVES. . : 0.
GAS PRESSURF. . . 50-1- 11P. . . . : 0 CLO DRYERS. . : 0
NO. OF AIR HANDLING UNITS OTHER UNITS. : I
FURN ( 100K BTU: 0 10000 cfm : 0 GAS OUTLETS. : I
TURN ) =100K B"l'U-. LA 10000 cfm : 0
Remav-ks : Install gas insert w/ gas piping in fireplace of an existing single
family dwelling.
Owner-: FEES
WIL.LJAM DEREK type amol.int by date r,ecpt
10305 SW HIGHI-AND DRIVE PRMT $ 25. 00 GEO 11 /20/97 97--301119
TIGARD OR 5PCT $ 1 . 25 GEO 11 /20/97 9-7-301119
Phone #: 620-5310
Contr-actot-: --------------------------------
. PRO GAS
RICK STICKA
686 SOUTH 25TH CT $ 26. 25 TOTAL
CORNELIUS OR 9711-3
Phone #: 887-3778
Reg #. . : 57068
REQUIPED TNSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All tork will be done in accordance with Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
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 OAR 952-00I-0010 through OAR W-WI-OW. You may
obtain copies of these rules or direct questions to OW by calling
(5@3)246-9187,
I/ IPev,m i t t ee Si gnat iav-e- T P X—
+++++++++++++++-4+++++++++++++++++++-+++++++++++++++++++•! .........V++4++-i.......
Call 639-4175 by 7:00 p. m. for inspe,:!tions needed the next bi-Isiness day
4•.........4++4..... .... ...........4-++4-+-I-+-f...............1-4 4 }++++++
Plan Check#
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
;GARD, OR 97223 Date to P E.
(503) 639-4171, x304 Date to GST
Print or Type Permit
Incomplete or illegible applications_will nCalled--
_
N_-,me of Development/Protect, / Description —
r��f�i'�'L!sL Table 1A Mechanical Code OTY PRICE'. AMT
Street Address Sude# A) Permit Fee
AC� � Sc,J NiL/ic,M,a d2, �--- -0- 1000
Address / 3 _
Bidga ci y1state Zip 1.) Furnace to 100,000 BTU 6.00
�_ — _including ducts 3 vents
Name for name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner,/j;�1 �p.�c IC _ including ducts&vents
Mailing Address 31 F;om Furnace - 6.00
%C'>C'> S't,,t #/GN[.HVJ Q� including vent
Cityrstate Zip Phone 4.) Suspended heater,wall heater 6.00
/-;e,-J""j OR &,)o - 53)41 or floor moun ad heater
Name(or name of business) 5.) Vent not incl,ided in appliance permit 3.00
Ll'1Lr'AM iblfrt—' K-
Occupant
K.Occupant Mailing Address 6) Boder or comp,heat pump,air cond. 6.00
/("',C'5 S I lar 6 to 3 HP;absorb unit to 100K BUT—
C /State zip Phone 7) Boiler or comp,heat pump,air Gond. 11 00
_ r L•.3f'4 C1 G3-15 HP; unit to 500K BTU—
Contractor NoR1e 8.) Boiler or comp,heat pump,air Gond. 15.00
15.30 HP; absorb und.5-1 mil BTU"
Prior to permit Mailing Address e r 9.) Boiler or comp, heat pump,;it Gond 22.50
issuance,a copy 6- sti S J — 30-50 HP;absorb unit 1-1 75.ail BTU"
of all licenses CdyrState Zip Phone 10) Boiler or comp,heat pump,air amd. 3750
are required if Cr y ArNr u? U�` s i) S.7.7 >50 H' rbsorb unit 1 75 mil BTU"
expired in COT Oregon Const Cont.Board Lic N Exp Date 11,) Air handling unit to 10,000 CFM a 5G
database _ %• _v
Architect Name 13.1 Non-portable evaporate cooler 450
or Mailing Address 14) Vent fan connected to a single duct — 300
Engineer Cdpstate Lp Phone 15) Ventilation system not included in — 4.50
1 appliance permit
Describe,t ork New O Addition O Alteration O Repair O 16) Hood served by mechanical exhaust 450
to be done Residential U Non-residential O
Additional Description of work^ l17) Domestic incinerators 7 50
18.) Commercial or industnal type 30.00
F_14 , '1eS'
_ Incmer for _ _
Existing use of 19.) Repai units 450
building or property
20) Wood stove 450
Proposed use of 21 ) Clothes dryer,etc 450
budding or property _
22) Other units 4.50 7 >
Type of fuel-oil O natural gas U LPG O electric O 23) Gas piping one to four outlets 200
I hereby acknowledge that I have read this application.that the 24) More than 4-per outlets(each) 50
information gr:en 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 cif 9wgerlAgent r Ite *SUBTOTALh ��
L�� /j � 5%SURCHARGE
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
( �`G<l j/`ItJGl j TOTAL
mechpmtdoc (rev 9 'Minimum permit fee is$25 *5%surcharge
"Resident-al AX requires si!e plan showing placement of unit