Permit A °� ; CITY OF TIGARD 0 MECHANICAL PERMIT
A' DEVELOPMENT SERVICES N,...PERMIT ISSU MEC1999 -00317
•� � ' ►, :- DATE TE ISSUED: 7/26/99
13125 SW Hall Blvd., Tigard, OR 97223 (503) 69 PARCEL: 2S103BD -07800
SITE ADDRESS: 12562 SW 115TH AVE VV
SUBDIVISION: HUNTER'S GLEN ZONING: R -4.5
BLOCK: LOT: 034 JURISDICTION: TIG
CLASS OF WORK: OTR 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: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of a/c unit. Placement of a/c unit must comply with standard setbacks.
Owner: FEES
TANYA WEBB Type By Date Amount Receipt
12562 SW 115TH AVE PRMT DEB 7/26/99 $50.00 99- 317140
TIGARD, OR 97223 5PCT DEB 7/26/99 $3.50 99- 317140
Total $53.50
Phone:
Contractor:
SUN GLOW
2428 SE 105TH AVE
PORTLAND, OR 97216 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: 253 -7789 Final Inspection
Reg #: LIC 00048131
ELE 141 LMS
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 No ' ' ation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You ay obtain pies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issu y: . Q[/p,yyt J ,/ Permittee Signature:, �i /� � , ,. , �,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
. /E
CITY OF TIGARD Mechanical Permit Application RE Plan Check C EIVED Recd By 7 mil/
13125 SW HALL BLVD. Commercial and Residential Date Recd - - �y
TIGARD, OR 97223 �,��,.�. �� JUL 2 P � 199 Date to P.E.
(503) 639 -4171, x304 ` Date to DS
Print or Type COMMUNITY DEVELoP Permit #1114/999.003)7
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 16.00
Address 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
� including vent see footnote 1,2 9.65
(
Owner Gt b \/ 6` 4) Suspended heater, wall heater
Mailing Addr ss
1 j� or floor mounted heater see footnote 1,2 9.65
I 9 5 S W 11 5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: `Boiler Heat Air
-i ' C 00e- ` ;j
�23 t _ For items 6 -10, see or Pump Cond Qty Price Amt
Nair r name 6f business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU 9.65
Occupant Mailing Address
p 7) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
Crty /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Contractor Name 9) 30-50 HP; absorb
Lry■____ (../-\ unit 1 -1.75 mil BTU 36.00
01.�� -1 ,-1 � 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy 2y 2.h -Se-- ( 05 11 Air handling unit to 10,000 CFM ?
of all licenses C' tate Zip Phone l 7.00 / r!,'C
are required if a t t ` -r---dl, 0( v„ i t, 23 77t 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.75
database `1' /3 I , S 2,00,3 - 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
Residential Commercial 0 48.25
19) Repair units
Additional information or description of work: , 8.40 •
. >^d 20) Wood stove /gas FP /other units /clothe dryer /etc.
6 ,s 11 _ A;( tor
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas talcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL "
S-U cc,
I hereby acknowledge that I have read this application, that the information 7% SURCHARGE ,. : 5 50
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL a 4
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only ' _` s
Sign4 f Owner /Agent Date TOTAL `'
1Gt a/ ai 7-2,2 _ Other Inspections and Fees: .
1 . Inspections outside of normal business hours (mininum charge -two
Contact Person Na Phone hours) $50.00 per hour
�1. /� 5(1-4 7 ),S
4 �-�7 _ G/ 2. Inspections for which no fee is specifically indicated (minimum
G �C / charge -half hour) $50.00 per hour
Foonotes for commbicial 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
A s ; f -e-
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5/30/00 Activities for Case #: MEC1999 -00317
1:53:29 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 7/23/99 BON MAIL No Hold DEB 7/26/99 i °,e°
MECA008 Create Permit 7/26/99 DEB DONE No Hold DEB 7/26/99
MECA730 Cooling Unt Insp 7/26/99 7/26/99 No Hold DEB 7/26/99
MECA799 Final Inspection 7/26/99 7/26/99 8/9/99 MS FAIL No Hold AKJ 8/9/99 no one home
MECA060 (F) Issue permit 7/26/99 DEB DONE No Hold DEB 7/26/99
MECA845 Request inspection research 3/27/00 JMT DONE No Hold JMT 3/27/00
MECA880 Expired by limitation 4/18/00 HAP DONE No Hold AKJ 4/18/00
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