Permit T� r
CITY OF T
em MECHANICAL
u , DEVELOPMENT SERVICES PERMIT
'!� ��� � . 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # - MEC96 -0374
DATE ISSUED: 11/13/96
PARCEL: 1S135AA -00901
SITE :ADDRESS.:. .10230 SW 90TH AVE
SUBD:IV,I STONe..e "TOWN–OF ;METZGER- ZONING: R-4.5
BLOCK — ........: LOT— . . — . —
CLASS OF WORK. .:ALT FLOOR FURN - 0 EVAP COOLERS: 0
TYPE OF USE - -SF •• •UNIT HEATERS; : 0 VENT FANS...: 0
'OCCUPANCY GRP. -:A1 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. .....° 0 BOILERS /'COMPRESSORS HOODS - 0
FUEL TYPES 0 -3 HP - 0 DOMES. INCIN: 0
3 -15 • HP..•o --- .: 0 ••. COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP. : 0 REPAIR UNITS: 0
FIRE DAMPERS ?. < : • •i 30 -50 HP... : 0- • WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP - 0 CLO DRYERS..: 0
NO. OF UNITS= - - -• . • . - • AIR HANDLING .: UNITS : OTHER UNITS.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0. • • • > , 10000 cf -m': 0 ;- •,,
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Remarks: heating conversion from electrical to gas
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Owner: – ,. FEES .
JEFFREY KROO type amount by date recpt
10230 SW 90TH - • • ; ' 'PRMT $ 25.00 JMH 11/13/96 96- 286429
5PCT.$ 1.25 JMH 11/13/96 96- 286429
TIGARD OR. 97223
Phone #: 237- 8556(PGR)
Contract or: --
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALAT•IN OR 97062 • •
Phone #: $ 26.25 TOTAL
Reg #..: 005193 -
•REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Ins p
Tigard Municipal Code, State of Ore. Specialty Codes and all. other
applicable laws. All work will be , done in accordance with • Mechanical Insp
approved plans. ; This permit will expire iftworkl•i's,•not started , ; • Misc. Inspect ion
within .1805 days of issuance; • or if-work is suspendeUfor :more F i n a lF: Inspect i, o n.
than 180 days. ,. • .• .
- , A � nn
Permittee Signature': �4 Xl� L III _
. .„..
Issued B y:. ._ d��!.R / U
Cal for inspection, 639- 4175•
- ,• Plan Check #
CITY OF TIGARD Mechanical Permit Application.. i Recd By ' -
13121'Si/ii BLVD. Commercial and Residential '' � • . , Date Redd
TIGARD, OR 97223 y ; r. Date to P.E
(503) 639 -4171, x304 r • Date to DST_
Print or Type - Permit # -
Called ( t
Incomplete or illegible applications will not be accepted •
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE 'AMT a
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address I C 0 30 S •LO q C '� i
Bldg# City /State Zip B) Supplemental Permit - 3.00
`r) Le fD I CC 9 7a
Name (or name of business) 1.) Furnace to 100,000 BTU • 6.00
Owner k k - E K i`c' 0 incl. ducts & vents 1
Mailing Address 2.) Furnace 100,000 BTU + 1 7.50
IC 0 30 S. L c j C' incl. ducts & vents
City /State Zip Phone 3.) Floor Furnace fi.00
L Fier) , o K.. 9 -- ia o 9 g5. 4 /0 ° ,3 incl. vent
Name (or name of Cosiness) 4.) Suspended heater, wall heater 6.00
i s -r_t : PAn t �*/ 2 .. t � . _:
occupant Mauling Address 5.) Vent not incl. in 3.00
appliance permit
City /State Zip Phone 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP: absorp unit to 100K BTU -
N8rt1e 7.) Boiler or comp, heat pump, air cond. 11.00
4e eoLJ flier F/ A ,3 IC R (..- . 3-15 HP; absorp unit to 500K BTU
Contractor Mailing Address 8.) Boiler or comp, heat pump, air cond. 15.00
15-30 HP; absorp unit .5-1 mil BTU
rAttach copy of city /State Zip Phone 9.) Boiler or comp, heat pump, air cond. 22.50
Current Licenses 30-50 HP: absorp unit 1 -1.75 mil BTU •
Oregon Const. Cont. Board Lic.# Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
t > 50 HP; absorp unit 1.75 mil BTU
COT Business Tax or Metro a Exp. Date 11.) Air handling unit to • I : 4.50 i
10,000 CFM -
Architect Name 12.) Air handling unit 7.50
10,000 CTM + _
or Mailing Address 13.) Non portable - 4.50
evaporate cooler - -
. Engineer City /State Zip Phone 14.) Vent fan connected 3.00
` to a single dud
Describe work New 0 Addition 0 Alteration 0 Repair 0 15.) Ventilation system not 4.50
to be done Residential Cron residential 0 included in appliance permit •
Additional Descnption of work 16.) Hood served by mechanical exhaust 4.50
* H 77 aJL' CL tJ ‘.7 ET S10+J OfY)
,!Z CZ7 ri-L 7 (, II -3 ( -P L) 17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrialtype 30.00
building or property I incinerator , l'' '
19.) Repair units I I 4.50 I I
Proposed use of 20) Woodstove . :{ a t, . 4.50
building or property
21) Clothes dryer, etc. ,_ 4.50
Type of fuel - oil 0 natural gas 0 LPG 0 electric 22) Other units 4.50
',14'.,
I hereby acknowledge that I have read this application, that the 23) Gas piping one to four outlets - , 2.00
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State 24) More than 4-per outlet (each) .50
laws.
S'gnature o er Agent Date QTY.SUBTOTAL , 1 Q QC, t
' `SUBTOTAL V
Contact Person Name Phone 5% SURCHARGE ,
PLAN REVIEW 25% OF SUBTOTAL
i :ldstlmechpmt.doc (rev 7/96) 'Minimum permit fee is $25 surcharge `
-) -
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service AL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing Mec .
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: I C, _
Date: 1 1 I 4 l• 6-7 A.M. P.M. 3 Entry:
Address: ) b Z 3D 9e !"1v r
Tenant: Ste:
Con /Own: g 'T 9 3 OH
, M: 231 0 s Q') / ELC:
THE FOLLOWING CORRECTIONS AR REQUIRED: ELR:
f
Id
Inspector: �/ Date: (/y ;
/ PP
ns ROV DISAPPROVED /CALL FOR.REINSP. CF CO
CITY OF TIGARD BUILDING INSPECT! N NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. ech. Rough- Gyp. Bd. -Bldg.
San. Sewer s in Appr/Sdwlk Reins.
Other: c� G 3 ) (3' " 0 --e>±
Date: i 1 / 1 ( A.M. P.M. Entry:
Address: / 6 Z 3Q O S
Tenant: Ste: MST:
BUP:
Con /Own: l •: - _4 "L-- MEC:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
tar zr
1-7.7 rc-s. CA PP > .
G s rnl�L -c�
Inspector: Date: //;/r7
_APPROVED _ DISAPPROVED /CALL F CF CO
6/6/00 Activities for Case #: MEC96 -00374
•
3:08:01 PM
Assigned Hold Updated
Activity Description Date I Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 11/13/96 JMH MAIL J *H 11/13/96
MECA705 Gas Line Insp 11/7/96 1/9/97 KS APP KBS 1/10/97 # -1- 50 psi for 15minutes
MECA715 Mechanical Insp 11/7/96 1/9/97 KS DIS KBS 1/10/97 # -1- installation incomplete at
this time; call for final
MECA799 Final Inspection 11/7/96 1/14/97 KS APP KBS 1/15/97
MECA060 (F) Issue permit 11/13/96 JMH PAID J *H 11/13/96
MECA715 Mechanical Insp 1/14/97 KS APP KBS 1/15/97 •
MECA800 Case Finaled 1/1/97 KS APP KBS 1/15/97
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