Permit • CITY OF TIGARD MECHANICAL PERMIT
� � DEVELOPMENT SERVICES PERMIT #: MEC2000 -00108
' „� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/30/00
PARCEL: 1S125DA-07700
SITE ADDRESS: 09245 SW 69TH AVE
SUBDIVISION: KINGS VIEW ZONING: R -4.5
BLOCK: LOT: 076 'JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. 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: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Install a new freestanding gas stove and gas piping in single family dwelling.
Owner: FEES
TOMASOVIC, ROBERT S AND Type By Date Amount Receipt
DENISE B PRMT KJP 3/30/00 $50.00 0001061
9245 SW 69TH AVE 5PCT KJP 3/30/00 $4.00 0001061
TIGARD, OR 97223
Total $54.00
Phone:
Contractor:
FIRESIDE DISTRIBTRS OF ORE INC
•
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Gas Line lnsp
Phone: 503 - 684 -8535 Misc. Inspection
Reg #: LIC 00040979 Final Inspection.
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 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_cop of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: Permittee Signature: 7'IL.CLJ'
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Che
CITY QF TIGARD Mechanical Permit Application Rec'd By
1125 SW HALL BLVD. RECEIV VPnmercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 WAR 2 7000 Date to DST r
Print or Type Permit # � C�.Z coo -00 /di
COMMUNITY DEYELOPME1.I Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
G D 5 COq IN PiVe Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 16.00
1) Furnace to 100,000 BTU
Address including ducts & vents see footnote 1,2 9.65
aldg# -- ci Z„ 2) Furnace 100,000 BTU+
I )� s e 7 09- 97 'j2 ' including ducts & vents see footnote 1,2 12.00
Name (or name of business ^ • 3) Floor Fumace
Owner ' --Q._ 1 o « a sou ‘ c,\ - including vent see footnote 1,2 9.65
Mailing Addre „ (} 4) Suspended heater, wall heater
k (Ni yr or floor mounted heater see footnote 1,2 9.65
5) Vent not included in appliance permit 4.75
City/State Zip Phone Check all that apply: 'Boiler Heat Air
• For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU 9.65
Occupant Mailing Address 7) 3-15 HP;absorb unit
100k to 500k BTU 17.65
City/State Zip - Phone 8) 15 - HP; absorb
unit .5-1 mil BTU 24.15
9) 30-50 HP; absorb
Contractor lame 1 D unit 1 -1.75 mil BTU 36.00
¥ ; r 2 du L) i s4 c4 Of Q � 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy 9)3�a Su Q llll�� .) t' ?ir ir LI 11 Air handling unit to 10,000 CFM
of all licenses /tee Zip r P 1e 7.00
are required if '1 i�- °l11.�� (s 4 -S 5 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. on Board Lic.# Dat 11.85
database k. -1 1 I 2'{ 13) Non - portable evaporate cooler
Architect N8rt18 7.00
14) Vent fan connected to a single duct
4.75
or Mailing Address
15) Ventilation system not included in
appliance permit 7.00
Engineer City/State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
12.00
New 1b Repair 0 Replace with like kind: Yes O No O 18) Commercial cr industrial type incinerator
Residential l®' Commercial 0 48.25
19) Repair units
Additional information or description of work:
r e_sz, Q` ` 20) Wood stow gas FP/ then units /clothe dryer /etc. SA cx.,.S2�.�.st v-•e _ i 7.00 7 . o°
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets 1 structural gas calks. See footnote 1 3.75 3.
Type of fuel: oil 0 natural gas 0 LPG 0 electric O 22) More than 4 -per outlet (each) .
Minimum Permit Fee $50.00 SUBTOTAL SO
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE ( 4 . 00
given 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 State laws. . Required for ALL commercial permits only . ^�
TOTAL S ‘ W ;
Signal of Owner/ . ent Date -
��� Z Other Inspections and Fees:
r
�� ; � CO)-- Z
60 1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name Phone hours) $50.00 per hour
And 2 Inspections for which no fee is specifically indicated (minimum
01�(I �A /4r\A ff ll�� ` S3S charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge -one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
units. "Residential A/C requires site plan showing placement of unit
I:\rnechperm.doc rev 7/19/99 _
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested Y■ 00 AM PM ) BLD
Location q Z 4- iS Coq(- Suite p S MEC 2000-03/
Contact Person , - Y)✓I�. Ph (S9b � 1'b JS PLM BOO '00/0Z.,
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing c� c•4/� /e/L d ci, / / ( .(,f £ /Zt� K2 (coo 5
Fire wall h 5$" c cY /t c/ r1
Fire Sprinkler GcrA -.47 �R /� � �/ i � l� �rr / �./Q cam/
Fire Alarm C `/ w I_ Cc' /
Susp'd Ceiling � �/j�
Roof
Misc:
Final
PASS PART FAIL
LUMBING2 / Lo G / 61/
&
PosT Beam // _� v
Under Slab / Derarz» / P !� (� C2� /
Top Out
Water Service / Gu'j9'72- ,4 e T�GZ
Sanitary Sewer
R. Drains
i ' :��
ART FAIL
Post & Beam
380/3K
Rough In
Gas Line
Smoke Dampers
PASS OM FAIL
ELECT
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA
Approach /Sidewalk Date c72/ZIO , J V Inspector I T Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.