Permit A C ITY OF TIGARD MECHANICAL PERMIT
il* A DEVELOPMENT SERVICES PERMIT #: MEC2000 -00308
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4 DATE ISSUED: 07/28/2000
PARCEL: 1S134DC-05200
SITE ADDRESS: 11700 SW 113TH PL
SUBDIVISION: MUTTLEYS ADDITION ZONING: R -4.5
BLOCK: LOT: 023 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: 1
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: 1
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of fireplace insert and ventilation system.
Owner: FEES
MOCZNLSKI, STEVE & MEGAN Type By Date Amount Receipt
11700 SW 113TH PL PRMT DLH 07/28/20( $50.00 0004073
TIGARD, OR 97223 5PCT DLH 07/28/20( $4.00 0004073
Phone: 431 -2005 Total $54.00
Contractor:
HOMESTEAD STOVE COMPANY
2729 NE BROADWAY
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 282 -3615 Final Inspection
Reg #: LIC 85707
•
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 obtai copies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: Permittee Signature:, G
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Check #
CITY OF TIGARD Mechanical Permit Appli 'on Recd By
13125 SW HALL BLVD. Commercial and Resi Date Rec'd
TIGARD, OR 97223 '10 %15 Date to P.E. Dae to DST
(503) 639 -4171, x304 �� �.�� v�� O e��� / ' � Pe # /`IEC , ?�71 =4n'� a8
Print or Type p�
Incomplete or illegible applications will be accepted
Name of Develo Called cr
Table 1A Mechanical Code Qty Price Amt
Job Street Address �/ suite# A) Permit Fee 'A t r 10.00
Address II - S L 1 I . 1M 1 "" 1) Furnace to 100,000 BTU
including ducts & vents 6.00
e g# City/State Zip 2) Furnace 100,000 BTU+
' including ducts & vents 7.50
Name (or name of business) 3) Floor Furnace
M r including vent 6.00
Owner � Ve 1` { nGZ ►'� S 4) Suspended heater, wall heater
Mailing Address
+ ) � cti.)-- 1 I > n / or floor mounted heater 6.00
I 5 II l� 5) Vent not included in appliance permit
City /State Z P _ 3
I ( 7-3 ? CHECK ALL *Boiler Heat Air
Name (o me of business) THAT APPLY: or Pump Cond Qty Price Amt
Comp **
-
' 6) <3HP;absorb unit to
Occupant Mailing Address 100K BTU 6.00
7) 3 -15 HP;absorb unit
City /State Zip Phone 100k to 500k BTU 11.00
8) 15 -30 HP; absorb
91 mil BTU 15.00
Contractor Name 9) ) 30-50 HP; absorb
'es 1'1(1.
■•&ki unit 1 -1.75 mil BTU 22.50
Prir pa copy M n9 ;dd,[est ` ,E OrWatelAg >1.75 >5 B sorb unit
issuance, a copy `�L. �d-' N >1.75 mil BTU 37.50
of at licenses /state � - 7 � Zip P e 11) Air handling unit to 10,000 CFM
are required if 0 l23z .Z TZ 3101.5 4.50
expired in COT r egon Con C ont. Board Lic.# Exp Date 12) Air handling unit 10,000 CFM+
database VS _ 9 /r/rD 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 r. -
Engineer City/State Zip Phone appliance permit It
i 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes 0 No 0 7.50
Residenti Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
4.50
20) Wood stove f �(--�
C W>WVI'yl . 4.50
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gas 0 LPG 0 electric O , �f 22) Other units
4.50
I hereby acknowledge that I have read this application, that the a ion 23) Gas piping one to four outlets
given is correct, that I am the owner or authorized agent of 2.00
the owrjt r, that pla • bmitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
Ai b
.50
AWE
Signa •f �r ent f Date , . 112
Si
°7 M Permit Fee SUBTOTAL . v
ryr�� t�:
D% SURCHARGE
Con t• P on Name Phone PLAN REVIEW 25% OF SUBTOTAL
e U ,,s, / ^ 2 p _ Required for ALL commercial permits only
r YLa.+ O., TOTAL
v *State Contractor Boiler Certification required
* *Residential A/C requires site plan showing placement of unit
I:\rnechperm.doc rev 07/20/98
CITY OF TIGARD-BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
)
Date Requested AM PM - LD
Location // 700 5 // 2 Pt- Suite MEC 26 cia3a5
Contact Person v-P Ph T3 C — v )� PLM
Contractor ,,1 , [ Ph SWR
BUILDING Tenant/Owner ` Al/ J A /- 4e- {' 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
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
Final
PASS RT FAIL
CHANICA1
am
Rough In ri Gas Line ti j-e 1/1* c,!
Smoke Dampers ( ` �
Fin
ASS ART FAIL
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
Other Date ' 3 — � Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.