Permit CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2000-00181
allir
' ' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/22/2000
PARCEL: 2S1 12 DC -01300
SITE ADDRESS: 15930 SW 74TH AVE
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT: 035 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Install HVAC and duct work to existing bldg.
Owner: • FEES
LA RUSSO CONCRETE Type By Date Amount Receipt
15930 SW 74TH PRMT GEO 05/04/20C $50.00 0001913
TIGARD, OR 97224 PLCK GEO 05/04/20C $12.53 0001913
5PCT GEO 05/04/20C $4.00 0001913
Phone: Total $66.53
Contractor:
AMERICAN HEATING
1339 SW GIDEON ST.
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 239 4600 Mechanical Insp
Reg #: LIC 00033135 Heating Unt Insp
Duct Inspection
Final Inspection
PRIMAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 001 -0080.
You may obtain,eopiespf ,bse rul r..rdirect questions to OUNC by callin /yc), 6 -9
Issue By: 4 . 0{ • --- -Pe rmittee Signature
Yf C 4
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next busi • -ss day
Plan Check #-5 - 7/6)
CITY OF TIGARD Mechanical'Pernlit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd .-5 y
TIGARD, OR 97223 Date to P.E. 5----,//- o d
(503) 639 -4171, x304 Date to DST S12/02)/V
Print or Type Permit# MfE- A0o0 -46/$f
Incomplete or illegible applications will not be accepted 9 f6,-s Ay y
Name of Development/Project Description
LA jQi a s o `ON Cxie7t:fr- Table 1A Mechanical Code Qty Price Amt
Job Street Address suite# A) Permit Fee ATIMMait We (-
Address /6" Q a) 7 L 714
1) Furnace to 100,000 BTU
Bldg# city /state Zip including ducts & vents see footnote 1,2 6.00
2) Furnace 100,000 BTU+ n �
7 .4t xi O>� X7214 including ducts & vents see footnote 1,2 / 7.50 1 2
Name (or name of business) 3) Floor Furnace
Owner LA aNSJn C1v cA@'T6r including vent see footnote 1,2 6.00
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 6.00
154 3 0 cStJ 74 5) Vent not included in appliance permit
City /State Zip Phone 3.00 _
`17 4 of A4-37o i Check all that apply: *Boiler Heat Air
zfste (or name of business) For items 6 -10, see or Pump Cond Qty Price Amt
L //►► footnotes 1,2 Comp **
b t u331O aNCTtFSTir 6) <3HP;absorb unit to (r/S
Occupant Mailing Address 100K BTU / 6-80 q
/6°g gb S 1 L T i't 7) 3 -15 HP;absorb unit
City /State Zip ' Phone 100k to 500k BTU 11.00
77 tic) D�. 1�a3S 4$4 u) t .5-1 mi l absorb
� unit .5 -1 mil BTU 15.00
Contractor " • 9) 30 -50 HP; absorb
,.4011xe2i c-8a9 1JunST I M 1N L unit 1 -1.75 mil BTU 22.50
Prior to permit Mailing Address 10) >50HP; absorb unit
issuance, a copy 133q S A S. GI cliff 0As r >1.75 mil BTU 37.50
of all licenses Sty /state A Zip Phone 11) Air handling unit to 10,000 CFM
are required if ' L4 'j ) At Iwo 1 23o) OV 4.50
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 12) Air handling unit 10,000 CFM+
database 33 i $ 6 G01 ,6a - 7.50
Architect Name 13) Non - portable evaporate cooler
4.50
or
Mailing Address 14) Vent fan connected to a single duct
3.00
15) Ventilation system not included in.
Engineer City /State Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New tY Repair 0 Replace with like kind: Yes 0 No 0 • 7.50
Residential 0 Commercial 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
4.50
_Jde) . dUV-be 4- /JucT woRK To hax,iT 414,1 20) Wood stove
NOTE: For Commercial projects only; Units over 400 lbs. require 4.50
structural gas calcs. 21) Clothes dryer, etc.
Type of fuel: oil 0 natural gas IV LPG 0 electric 0 4.50
22) Other units
I hereby acknowledge that I have read this application, that the information 4.50
given is corre that I am the owner o' lthorized agent of 23) Gas piping one to four outlets
the owner, i n s mitt ar i pliance with Oregon St to laws. See footnote 1 / 2 A0 "7.1- 2 4) More than 4 -per outlet (each)
Signature of Owner/ gent Date/ .50
3 r - j , Bain - f a37' t /� f1V Minimum Permit Fee $25.00 SUBTOTAL r, j �D,
rfO
Contact Person Name Phone �,:f ,,,v e"
5% SURCHARGE - NiSlan
PLAN REVIEW 25% OF SUBTOTAL ' '
Foonotes for commercial projects only Required for ALL commercial permits only '. 1 '
1. Provide full schematic of existing and proposed gas line and pressure. TOTAL fir p / (_ 9)
2. Provide drawings to scale showing existing and proposed mechanical . (
units. *State Contractor Boiler Certification required
"*Residential NC requires site plan showing placement of unit
I:\rnechperm.doc rev 02/4/99
CITY OF TIGARD BUILDING INSPECTION DIVISION a MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
I � B uP •
1,
Date Requested 1/00 AM PM / g
Location ) � ; 0 I- 4 ,A't � �, Suite (D —(Y ! g'
Contact Person c V1�1:� l�-�'t Ph X7)9 4 - 1 06
Contractor Ph 7 7`• 2,5696 SWR
'BUILDING Tenant/Owner IA c \ - ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: 0 OZ
Slab `� L C� SIT
Post & Beam 1 , n
Ext Sheath /Shear
Int Sheath /Shear /� ,
Framing •b — V 2 � i& - • _ •
Insulation
Drywall Nailing ><� �& ' \ __'�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling (�
Roof /�1
Y V\ C'7-y �S r G `p��l C, S V 1
Misc: --7
Final 7 ,,,
PASS PART FAIL \ ` l o o ` �_ `�
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service r
Sanitary Sewer �"�
Rain Drains VV
Final
PASS PART FAIL ``� >� A
ANICAL
Pos earn
Rough In �1(t)/
Gas Line Ne i
Smo _ Dampers
final
PASS PART AIL
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk Inspector
) �
Other Date �� v
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
/ I BUP
Date Requested ,S/ 2 / O0 AM PM BLD
Location c 130 � ( 4 `t k Ale, Suite MEC MEC /1,00 — (D i R 1
Contact Person g b Z
% Ph - c I PLM
Contractor Ph 9 3 - 2 5b 6 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 \` • ` -�� .._ !� ! _%/ ��.
Firewall T ��
Fire Sprinkler_ i :i� _ ��..��_��Z �� _ —!'
Fire Alarm
Susp'd Ceiling
Roof --
Misc:
Final
PASS PART FAIL —' = � — � � : : !► _ 7 eil
PLUMBING _ -
Post & Beam
Under Slab
Top Out
r Service =' e� / 3 e -
Water
Sanitary Sewer
Rain Drains
Final
PASS PA At FAIL
ECHANIC gr C / ,$
b'
Pos Bea
Dampers
1 'r 't. it FAIL
CAL
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access.
ADA ,r
Approach /Sidewalk Date 2 ?/)1 Inspector � Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•