Permit 11 CITY OF TIGARD MECHANICAL
Ve .; DEVELOPMENT SERVICES PERMIT
' y����� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # ° MEC98— 199
DATE ISSUED: 06/03/98
PARCEL: 1 S 134CA- 005Q05
SITE ADDRESS...: 11175 SW 119TH AVE
SUBDIVISION....: PANORAMA NO.2 ZONING: R-4.5
BLOCK........... LOT... ...... ....:016 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/0 APPL: 0 VENT SYSTEMS: 0
STORIES - 0 BOILERS /COMPRESSORS HOODS - 0
FUEL TYPES 0 -3 HP - 0 DOMES. I NC I N: 0
:GAS 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 t= 10000 cfm: 0 GAS OUTLETS. ;:C
FURN > =1O0K BTU: 0 ) 10000 cfm: 0
Re marks : Mechanical addition
Owner: FEES
FRANK J LEE type amount by date recpt
11175 SW 119TH AVE PRMT $ 25.00 B 06/03/98 98- 306238
TIGARD OR 97223 SPCT $ 1.25 B 06/03/98 98- 306238
Phone # : 503- 579 - 1533
Contract or:
OWNER
26.25 TOTAL.
Phone #:
Reg #.
REQUIRED 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 Final Inspection _ .
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952- 001 -0010 through OAR 952 -.1' -0080. You may
obtain copies of these rules or direct questions to OUNC by calling -
1503)246 -9187.
Issue By: 6/Kittaar Permittee Signature:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check
CHI' OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd (o - '-
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, x304 Date to DST
Print or Type Permit # V i 0._ l �tc'
Called
Incomplete or illegible applications will not be accepted
e o ; en�Projed 0 ' 2, Description l 1A
w-v tVN �`"'• `+^- Table 1A Mechanical Code QTY PRICE AMT
Job Street Address .vIN Suite# A) Permit Fee
-0- -0- 10.00
Address 1 1 1 15 5 P.) .) 1'1 Av /
Bldg# I city /State Zip • 1.) Furnace to 100,000 BTU 6.00
II i6RtZk ( 1)?? • including ducts & vents /i" 0
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner I ■ , Lc E_ including ducts & vents
Mailing Address (\ 3.) Floor Furnace 6.00
) I fS %W. \ \ ' 4-)u e- including vent •
Ci /State Zip I Phone 4.) Suspended heater, wall heater 6.00
J LGt9R) of, 9 S - ( -151 or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
1 Li
Occupant Mailing Add ress 1. 6.) Boiler or comp, heat pump, air cond. 6.00
( ��1S 5U3.. \ \e( V) (---- to 3 HP; absorb unit to 100K BUT
Cu /State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
(^ . = i w ) ■ • 7. ._ - ' I . 4. 3-15 HP; absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
C�w �,,e� 15 30 HP; absorb unit.5 -1 mil BT 1
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 N / 12.) Air handling unit 7.50
10,000 CTM+
or Mailing Address 13.) Non - portable evaporate cooler 4.50
Engineer City/State Zip Phone 14.) Vent fan connected to a single duct 3.00
Describe work New 0 Addition 0 Alteration Repair 0 15.) Ventilation system not included 4.50
to be done Residential Non - residential 0 in appliance permit
Additional Description of work: 16.) Hood served by mechanical exhaust 4.50
GAS c•,- s-,.��. -S-k3--c\ _-\-:,".
17.) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial 30.00
/
building or property type incinerator
19.) Repair units 4.50
Proposed use of 20.) Wood stove 4.50
building or property+.
21.) Clothes dryer, etc. 4.50
Type of fuel : oil 0 natural gas fit. LPG 0 electric 0 22.) Other units 4.50
I hereby acknowledge that I have read this application, that the information 23.) Gas piping one to four outlets 2.00
given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State laws. 24.) More than 4 -per outlet (each) .50
Signature of Owner /Age t Date *SUBTOTAL , :t v„ i
5% SURCHARGE _ z r
�^ I
Don't rson ame Phone PLAN REVIEW 25% OF SUBTOTAL a
�i ` g
Required for all commercial permits only.
TOTAL ° z
*Minimum permit fee is $25 + 5% surcharge
"'Residential NC requires site plan showing placement of unit.
I:\rmechprmt.doc rev 4/15/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
p BUP
Date Requested �1 �7 i l AM PM BLD
Location I' (1 7 S ). � - 1 QQ A i Suite MEC 9g"- D i g
Contact Person ? Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner 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 1 '/ 46 - e f ; ?7 2Z -= 3D "="5:,_4"
Insulation
Drywall Nailing l5 _ //Pi/ ' s_) 37 3(e , 9 x'
Firewall
Fire Sprinkler ' ' 4 C J . . '✓t�rl�t �
Fire Alarm
Susp'd Ceiling 3 . i c .
Roof
Misc: � /4 {
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
<MCHANIC)
Post & Beam
Rough In
Smoke Dampers
Ana
PART 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 g 2 7 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.