Permit CI TY OF TIGARD OP/RE0 MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC1999 -00393
-� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/20/1999
PARCEL: 2S 103 B B - 11300
SITE ADDRESS: 12135 SW 123RD CT
SUBDIVISION: YE OLDE WINDMILL ZONING: R - 4.5
BLOCK: LOT: 032 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:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installing gas fireplace insert and gas piping
Owner: FEES
DAVE FLAMING Type By Date Amount Receipt
12135 SW 123RD PRMT BON 09/20/19C. $50.00 99- 318482
TIGARD, OR 97223 5PCT BON 09/20/19c $3.50 99- 318482
Total $53.50
Phone: 503 - 590 - 2331
Contractor:
T + K MECHANICAL
TIMOTHY S WYNNE
11525 SW CANYON REQUIRED INSPECTIONS
BEAVERTON, OR 97005 Gas Line Insp
Phone: 626 -4652 Misc. Inspection
Reg #: LIC 00121165 Final Inspection
ORIGINAL
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 obtain copies of these rules or direct questions to OUNC by
calling (503)24r 189.
Issue By: {��� (/( Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections nee .._ a business day
Plan Chec #
CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd -. 20 -
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST r
Print or Type Permit # lE- ��1`�: -cril3
00P°17- Incomplete or illegible applications will not be accepted Called
Name of Development/Project r F Description
(, , ( Table 1A Mechanical Code Qty Price Amt '
Job Street Address ' V �• � Suite# A) Permit Fee �' .f` 16.00
Address 17 i 35--
5 5 l 7 , J ( <! 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 9.65
Bldg# City/State Zip 2) Furnace 100,000 BTU+
f �
i' including ducts & vents see footnote 1,2 12.00
Name (or name of business) " 3) Floor Furnace
Owner pexVQ F/et rn i y! y including vent see footnote 1,2 9.65
Mailing Address / 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 9.65
' C 2.-/ 3 5 5c./ / 2- 3 `- / • 5) Vent not included in appliance permit 4.75
ity /State Zip Phone Check all that apply: *Boiler Heat Air
` r^-✓ ci• 51c7-2:331 For items 6 -10, see or Pump Cond Qty Price Amt
Na (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
Qom'? 100K BTU 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
104. to 500k BTU 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
9) 30 -50 HP; absorb
Contractor Name
�- // unit 1 -1.75 mil BTU 36.00
V- ln7c4f ` '_, 10) >50HP; absorb unit
Prior to permit Mailing Address / , � >1.75 mil BTU 60.15
--
issuance, a copy , Q�ji,s^ r T (/ r J, 3eg, 11 Air handling unit to 10,000 CFM
of all licenses City /st Zip Phone 7.00
are required if �LE - fg l 97� 3S7- y,/ N 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.85
database / 21 / 4 S 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: _pj a / ) � Q 7 G, Fo..�� -� 17) Domestic incinerators
* a /� 4-7-- 12.00
New 0 Repair 0 Replace with like kind: . Yes co O / 18) Commercial or industrial type incinerator
ResidentiaWr- Commercial 0 48.25
19) Repair units
Additional information or description of work: 8.40
I I 5 / i / - N � `r S 00 N 20) Wo stove/gas FP /other Ynits /clothe dryer /etc. / f
7� ( l� ( !t`� (1 "� 7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 / 3.75
Type of fuel: oil 0 natural gas` LPG 0 electric O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL a ",
I hereby acknowledge that I have read this application, that the information 7% SURCHARGE s �_
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL
the ow laps submitted are in compliance with Oregon State laws.
eep Required for ALL commercial permits only
_ TOTAL � r0
Signatu Owner/Age Z Date ~ �� �
Other Inspections and Fees:
r 'h e..+/ �,,r 'e_ 3S ( f �, l <f 1. Inspections outside of normal business hours (mininum charge -two
Contac Person Name ( Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
charge -half hour) $50.00 per hour
Foonotes for commercial 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:tmechperm.doc rev 7/19/99 __ _
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
q q BUP
Date Requested 9 - Z1' r I AM PM BLD
Location 1 2- 1 3S 1 Z- � j T C5l ' Suite MEC I 61 l 9-iQ0; 3
Contact Person Ph ' <7 -1- 1(e)/ / 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
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final I , ( eff
PASS PART FAIL
PLUMBING �,
Post & Beam ,p
Under Slab S ye
Top Out
Water Service IC EC f' f
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
‹ ItlIAI)
Post & Beam
1pers
ap PART FAIL
RICAL
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 _9 - '
Approach /Sidewalk Date Ins • ,
Other
Final
PASS PART FAIL DO NOT REMOVE this insp - - • n record rom the job site.
5/10/00 Activities for Case #: MEC1999 -00393 EXPIRED
PM RED
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 9/20/99 BON DONE No Hold BON 9/20/99
MECA008 Create Permit 9/20/99 BON DONE No Hold BON 9/20/99
MECA705 Gas Line Insp 9/20/99 9/20/99 9/21/99 LN PASS No Hold AKJ 9/21/99
MECA750 Misc. Inspection 9/20/99 9/20/99 No Hold BON 9/20/99
MECA799 Final Inspection 9/20/99 9/20/99 No Hold BON 9/20/99
MECA060 (F) Issue permit 9/20/99 BON DONE No Hold BON 9/20/99
MECA845 Request inspection research 3/28/00 JMT DONE No Hold JMT 3/28/00
MECA880 Expired by limitation 4/18/00 HAP DONE No Hold AKJ 4/18/00
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