Permit a 4 CITY OF TIGARD MECHANICAL PERMIT
`al'' DEVELOPMENT SERVICES PERMIT #: MEC1999 -00281
c �' l l 13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/29/99
PARCEL: 1S135DB-04300
SITE ADDRESS: 11285 SW 92ND AVE
SUBDIVISION: DOGWOOD RIDGE ZONING: R - 4.5
BLOCK: LOT: 1 - 2 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Remarks: Add gas piping for a free standing generator.
Owner: FEES
WILLIAM WEBBER Type By Date Amount Receipt
11285 SW 92ND PRMT GEO 6/29/99 $50.00 99/316510
TIGARD, OR 97223 5PCT GEO 6/29/99 $2.50 99/316510
Total $52.50
Phone:
Contractor:
THE GASMAN
8940 SE CLINTON ST
PORTLAND, OR 97266 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 522 -4795 Final Inspection
Reg #: LIC 127089
OG\NP¼L •
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 Ot R 9'2- 001 -0080.
You may obta of the or direct questions to OUNC by�r ing i 4.- 91-.9.
Issue By: � !�/ Permittee Signature
Call (503) 63•: 75 by 7:00 P.M. for inspections need ext business day
C ITY OF TIGARD Mechanical Permit Application Rec'dByck#
Plan
13126 SW HALL BLVD. Commercial and Residential Date Recd
TIGA OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST C�
Print or Type �' permit
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
J Street dd Address , Suite# A) Permit Fee ,' • ` 16.00
Address I /o2 OS / 5C ° G 1 V 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 _ 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
T t 3ci fii d q7,2a3 including ducts & vents see footnote 1,2 12.00
// Name (or name of business) 3) Floor Furnace
Owner W 1 I I; a ''1 (, j e l be, C including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
I G} '7 1 r or floor mounted heater see footnote 1,2 9.65
! / 5 S L) 6 0'• AU 5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
(► q< k ' dR 9 �.3q3 / For items 6 -10, see or Pump Cond Qty Price Amt
Na (or nameof business) footnotes 1.,2 Comp
5hV- / Glt?�V- 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 -30 HP; absorb
unit .5 -1 mil BTU 24.15 •
9) 30 -50 HP; absorb
Contractor Name - 't e. Gas tri An unit 1 -1.75 mil BTU 36.00
lY1Q5 LLlCKen[ooci 10) >50HP; absorb unit
Prior to permit Ailya,9 Address >1.75 mil BTU 60.15
issuance, a copy --/C) '5 V, CJ f - -C h j: ; 11 Air handling unit to 10,000 CFM
of all licenses -9V/State Zip Phone 7.00
are required if i L Q - R. c17p9,( 5 y7>S 12) Air handling unit 10,000 CFM+ '
• expired in COT oregon Cont. Board Lic.# Exp. Date f 11.75
database 7 7n 01 21 )66 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct •
or Mailing Address 4.75
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 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator
Residentiayi< Commercial 0 48.25 '
19) Repair units
Additional information or description of work: 8.40
20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one four outlets
structural gas calcs. See footnote 1 1 3.75
Type of fuel: oil 0 natural gasd LPG 0 electric O 22) More than 4 -per outlet (eac .75
Minimum Permit Fee $50.00 SUBTOTAL ,_ ,:,' ',,,, ‘, --
I hereby acknowledge that I have read this application, that the information 5% SURCHARGE ' °''',
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL ' i
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only
TOTAL _ '
Signatu - of own:r Date b' A
• A � 1029 q Other Inspections and Fees: .
� lc 1. Inspections outside of normal business hours (mininum charge -two
Conti " erson Name Phone hours) $50.00 per hour .
' f , L uC _ s �.- _ f /79s- 2. Inspections for which no fee is specifically indicated (minimum
b l'� a 7 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
units. *State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I:\mechperm.doc rev 02/4/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ q BUP
Date Requested 6 " 1 AM PM BLD
Location I l l S 9 V Suite MEC ) 519'"007_,K
9 '"602K I
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: / A [4
Foundation /V / / , m4 FPS
Ftg Drain / rG- SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
'PLUMBING
Post & Beam
Under Slab
Top Out -
Water Service
Sanitary Sewer
Rain,Drains 6;- "9,5 /inie C 7J5>9I2/ :a
Final L C /a C J
PASS PART FAIL J
Post & Beam
Rough In
as
mokeyampers
1:1 PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
k Lk%\
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: 7 [ ] Unable to inspect - no access
ADA
Approach /Sidewalk 6%(//7 Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.