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CITYOF T I G A R D McCHAK 7AL PERMIT
' UVELOPMENT $ PERMIT /: MEC2000.00060
1'3125 SW Hall Blvd., Tigard 31FW`4J�6 x.4171 LATEISSUFD: 2/28/00
PARCEL: 2S111 DD-16000
SITE ADI)RESS- 08643 SVV HAMLET CT
SUBDIVISION: MILLMONT PARK ZONING. R-7
BLOCK'. LOT: 037 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN. EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: 'vENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: __ B.0ILt:RS/C JMPRES_SORS HOODS:
FUEL 'VPES _ 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMM:_. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS _ OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Extension of gas piping for new gas range.
Owner: _FEES
WELLS, SF F,RON K + Type By Date Amount Receipt
OLSON, GI_ORGE P PRMT DEB 2/2.8/00 $50.00 00-321876
8643 SW HAMLET CT 5PCT DEB 2/28/00 $4.00 00-321876
TIGARD, OR 972 4
Phone: —
Tot ' $54.00
Contractor:
HOLMES INSTALLATION CERVICE
RAYMOND FLANDERS
33535 NW VADIS ROAD REQUIRED INSPECTIONS_
CORNELIUS, OR 97113
Gas Line Insp
Phone:647-9320 Final Inspection
Reg #:LIC 00102473
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is, not started within 180 ^lays of issuance, or,f work is suspended
fcr more than 180 days. Al TENTION: Oregon law requires you to follow rules adopted in the Oregon
I ' ility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00 '0.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: /Perm ittee Signature: ._-
Call (503) 133344--75 by 7:00 P.M. for inspections needed the next business day
CITY OF TIGARD Mechanical Permit Application RecABy _
y
13125 SW HALL BIND. Commercial and Residential Date Rec'd '� , ._
TIGARD, OR 97223 Date to P.E.
(503) 619-4171, x5J4 Date to DSTr
Print or Type Permit# A -doo
Incompi ate or illegible applications will not be accepted Called _
Name of Development/Project Description
Table 1A Mechanical Code Qty I Price tmt
Job Street Address Sulte# A) Permit Fee 13.00
Address , SOA b JgaaJ 1) Furnace to 100, - BTU
Bldg# Cay/State Zip including ducts&vents 9.65
2) Furnace 100,000 BTU+
Including ducts&vents _ 12.00
Name(or name of busine•.$) 3) Floor Furnace
Owner ^ 1". l�j Includm event 9.65
Mailing Address 4) Suspended heater,wall h.ater
6-r,_1 or floc, mounted heater 9,65
5 Vent not included in appliance ermit 4.75
CRY/tat Zip Phone Check all that apply: 'Boiler Heat Air
_ 0 For Items 6-10,see or Pump Cond Qty Price Amt
Name(or name of business) footnotes 1,2 Corn ••
r:t O/ 6)Repair units
Occupant OccU Mailing Address 8.40
P 7)<3HP;absorb unit to
( 1 T 100K BTU 9.65
CRY/Slate zip Phone 8)3-15 HP;absorb unit
%' . �� ��o _7 100k to 500k BTU 17.65
COrtrslctOr 'f°� 9) 15-30 HP;absorb
unit.f,-1 mil BTU 24.15
j( ' / ' 10)30-50 HP;absorb
Prior to permit Mailing Address unit 1-1.75 mil BTU 3600
issuance,a copy 3.3 t* -�.1, N w '", 11)>50HP;absorb unit X1.75 mil BTU
of all licenses CRY/State Ziprhone
required if ) 60.15
are re
Q s i3 v ACL 112)Air handling unit to 10,000 CFM
expired In COT Oregon Const Co,t Board Lic# Exp Date
database (/'1 1 7_0`2 7.00
,_11� 1 ��� 13)Air handling unit 10,000 CFM+
Architect Name _ 11.80
14)Non-portable evaporate cooler
Or Melling Address � 7.00
15)Vent fan connected to a single duct
L n sneer CRy/stete zip Phone 4.75
9 16)Ventilation system not included in
_ appliance permit 7.00
Describe work!c to done: 17)Hood served by mechanical exhaust
7.00
New 0 Repair Replace with like kind: Yes O No O 18)Domestic Incinerators
Residential* Commercial O Modification O 12.00
19)Commercial or Industrial type incinerator
Additional Information or description of work _ 48.25
10) Other ui;ts,including wood stoves
7.00
NOTE: For Commercial projects only;Units over 400 lbs,located on the 21)Gas piping one to four outlets
roof,require structural calcs,prepared by licensed engineer. 3.75
Type of fuel oil O natural gas 4 LPG 0 electric O 22)More than 4-per outlet(each) .75
I hereby acknowledge that I have read this application,that the information Minimum Permit Fee$50.00 SUBTOTAL— 8%SURCHARGE T �
given i3 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 State laws. Required for ALL commercial permits only
Ipnature of Owner/Agent Date TOTAL
ti�1,c•- �",� 7 ..._ c.) Other Inspections and Fees
Contact Person Name Phone
1 Inspections outside of normal business hours(minimum charge-two hours) $50 00 per hour
tl�G y' tib//t 6�7• f 3'2 L 2. Inspections lot which no fee is specifically indicated (minimum charge-half hour)
L2.
onotes for cnmmerclal projects only: $50 ooperhour
3. Additional plan re�oew required by changes,additions or revisions to plans(minimum
Provide full schematic of existing and proposed gas line and pressure charge-one-half hour)$50 00 per hour
Provide drawings to scala showing existing and proposed mechanical *State Contractor Boiler Certification required
units_ -Residential AIC requires site plan showing placement of unit
I Vrochperm.doc rev 11/1/99
CITY OF "'IGAR! - BUILDING INSPECTION DIVISION MST
24-Hour Inspection Lin( : 639-4175 Business Line: 639-4171
! BIJP
_II -
_Date Requeste ' __, AM PM — BLD _
Locatirn I.�, (.� � C�.t•� 2 Suite
Cont&,;t Person _ RIC Ph (�' c _2 0 PLM ---
Contractor Ph SWR
BUILDING — - Tenant/OwnerELC
Retaining Wall _--- — - ELR --_
Footing Access.
Foundation FPS
Ftg Drain -
Crawl Drain Inspection Notes: . _1 .AGN
Slab _ -
__C� n
�C —' SIT
Post&Beam ( 1`aJ R.tA.� S v A"r.� ,
Ext Sheath/Shear
Int Sheath/Shear - ' --
Framing!�' e1..t ►= �-. T��-- /5' j� Sal �°� l
Insulation
Drywall Nailing /N'yTLS &-rp S)-;P` Saco l�
Firewall
Fire Sprinkler 4- _ l=i.�r/IL I/� r��G0,.v �A Jc4
Fire Alarm
Susp'd Ceiling nor-'
Roof
Mise
Final
PASS PART FAIL _—
PLUMBING -
Post& Beam — - --- — --
Under Slab
Top Out ---- --- —__—_ _ — ---------
Water Service
Sanitary Sewer -
Rain Drains
Final ------- -------- --_ - - _
PASS PORT FAIL
Post&Bei -- _---- — --- --- - — —
RoIn
Gas Lin
Smo a Damoers — ——
Fi ., __._ ----------- ----- — --- —--—
AS$� FART FAIL
ELECTRICAL .—
Service
Rough In -
UG/Slab
Low Voltage —
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill/Grading - -- -- ---- — • -
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call for reinspection RE:__— — _ ( J Unable to inspect-no access
ADA
Approarh/Sidewalk
Other Date Z 2-12 -M Inspector Ext
Final ---- ,�
PASS PART FAIL 00 NOT REMOVE this inspection record from the job site.