Permit CITY OF T MECHAN I CAL
PERMIT
�<� DEVELOPMENT SERVICES PERMIT # • MEC98 -0104
� � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 03/19/98
PARCEL: 1 S 134DA -01400
SITE ADDRESS...: 11095 SW 106TH AVE s
�
SUBDIVISION • NORTHERN PINE 6 ZONING: R -4.5
BLOCK LOT •005 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES • 1 BOILERS /COMPRESSORS HOODS : 0
FUEL TYPES 0 -3 HP • 1 DOMES. INCIN: 0
3 -15 HP • 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS?..: 30 -50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 1O0K BTU: 1 (= 10000 cfm: 0 GAS OUTLETS. : 1
FURN > =1O0K BTU: 0 ) 10000 cfm: 0
Remark s : Install new furnace including ducts 6 vents, new A/C unit and gas
piping for an existing single family dwelling. A/C units may not incroach into the
required setbacks.
Owner: - FEES
STEVE R KOSKI type amount by date recpt
19600 SW LELAND ROAD PRMT $ 25.00 GEO 03/19/98 98- 304282
OREGON CITY OR 97045 SPCT $ 1.25 GEO 03/19/98 98- 304282
Phone #: 656 -9992
Contract or:
OWNER
$ 26.25 TOTAL
Phone #:
Reg #..: 999999
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Heating Unt Insp
approved plans. This permit will expire if work is not started Cooling Unt Insp
within 180 days of issuance, or if work is suspended for more Duct Inspection
than 180 days. ATTENTION: Oregon law requires you to follow rules Misc. Inspection
adopted by the Oregon Utility Notification Center. Those rules are Final Inspection
set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue By: ` i � - Per^mittee Signature:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++- F++++++++++-++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Permit # /#,Fe` -6 /0 ( f
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Development/Project I Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address j 1 ()S S J O - +L.
Bldg# City/State Zip 1.) Furnace to 100 BTU 6.00
-.--- a -c� Ct2 7 �� including ducts & vents (z)
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner '5 - / . 4z� lc . including ducts & vents
Mailing Address , 3.) Floor Furnace 6.00
5 < Ze /. --,,.( i2'.-€ . including vent
City/State r/ Zip Phone 4.) Suspended heater, wall heater 6.00
cl■C'e , -'X q xxes- or floor mounted heater
Name (dr name of busine §s) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00 rr
to 3 HP; absorb unit to 100K BUT" 1pw CL
City/State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"'
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy 30 -50 HP; absorb unit 1- 1.75mi1 BTU"
of all licenses City/State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if > 50 HP; absorb unit 1.75 mil BTU*
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database
Architect Name 13.) Non - portable evaporate cooler 4.50
Or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City/State Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional Description of work: 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas 0 LPG 0 electric 0 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL p
laws. q•
Signature of Owner /Agent Date 'SUBTOTAL
"/ / 1V-1- - --' s /Z--e - . C� ' _ L "- 5% SURCHARGE
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
TOTAL
ilrnechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit
(_0-
. •
t
0 c0 '
- - — e
Z:T i !
5 - h
(
22'
tt) t74
f8 11 (1
104
// 35 / 15 / 24 / 27 /3/
\
12
\ W2424BUTT \
12 W 1536L W2736
0
12
0 0
25 l
\ - < fl 84
\
0 0
0 00 0
34 B15L SB24BUT B15R BEOS122
\ \ \\
•
35 / 15 24 15 12 7
All dimensions & size designations THE This is an original design and must Sc
given Dwg no.
given are subject to verification on not be released or copied unless Designer
job site and adjustment to ft job HOME DEPOT applicable fee has been paid or job
conditions. order placed. Wall # 3
•
6/16/00 Activities for Case #: MEC98 -00104 44.
3:27:24 PM A �
Assigned Hold Updated O
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 3/19/98 GEO RECD DST 3/19/98
MECA008 Create Permit 3/19/98 GEO DONE DST 3/19/98
MECA705 Gas Line Insp 3/19/98 3/23/98 KS APP KBS 3/23/98 #-1-thirty psi for fifteen minutes
MECA715 Mechanical Insp 3/19/98 3/23/98 KS DIS KBS 3/23/98 #-1- obtain electrical permit for
new circuit for a/c unit #-2- seal
all penetartions at garage
firewall #-3- flex duct not
allowed to penetrate garage
firewall #-4- seal around a/c
return lines and gas piping at
ext #-5- grout protective barrier
front of mechanical #-6- support
gas piping 3/4 at eight ft 1/2 at
six ft and at each change of
direction
MECA725 Heating Unt Insp 3/19/98 DST 3/19/98
MECA730 Cooling Unt Insp 3/19/98 DST 3/19/98
MECA735 Duct Inspection 3/19/98 DST 3/19/98
MECA750 Misc. Inspection 3/19/98 DST 3/19/98
MECA799 Final Inspection 3/19/98 DST 3/19/98
MECA060 (F) Issue permit 3/19/98 GEO PASS DST 3/19/98
MECA715 Mechanical Insp 3/20/98 KS FAIL J *H 3/23/98 1. Mechanical installation not
complete. 2. Extend gas piping
to furnace and water heater
(prior to test). 3. Protective
barrier at front of mechanical. 4.
Insulate plenum and can to 4 -8
value, cover with FS paper. 5.
Strap water heater. 6. Call for
electrical inspection. 7. New
circuit for AC unit.
MECA750 Misc. Inspection 2/23/00 2/23/00 2/23/00 JMT DONE No Hold JMT 2/23/00 research inspection request
MECA880 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
Page 1 of 1