Permit CITY OF � MECHANICAL
DEVELOPMENT SERVICES PERMIT
��u~�=�~~�~n n�n~~"�" ��u~""�"~�m~~� PERMIT #..... MEC97-0015
~3* 31. 13125 SN/ Hall BlvL Tigard, OR97223(03)G39-4/7? DATE ISSUED: 01/27/97
PARCEL:' 251169BB-01800
SITE ADDRESS—,: 12395 SW-CORYLUS-CT '
SQBDIVISIONAMES ORCHARD ZONING: R-1
BLQCK..........: LOT.............:7
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 ^ 2 ' .• BOILERS/COMPRESSORS HOODS.......: 0
FUEL TYPES ----- 0-3 HP....: 0 DOMES. INCIN: 0
:/GAS/ / / '�- ,�
MAX INPUT: 0 BTU 15-30 HP....: 0 REPAIR UNITS: 0
FIRE. DAMPERS?.*:. ^���''� �` .�*''�� G/p�' ..�_ � WOODSTOVES..1, 0� .
GAS PRESSURE...: L 50+ HP....: 0 CLO DRYERS..: 0
NO. OF UNITS 777– AIR, HANDLING. UNITS , .OTHER. UNITS. :, 3~
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN >=100K BTU: 0' • > 10000 cfm: 0 ._
Remarks: INSTALL 2 GAS FIREPLACE INSERTS (ONE LIVING ROOM, ONE FAMILY ROOM) AND
NEW WATER, HEATER_ TO HOME NEVER SERVED BY GAS BEFORE (AND PIPING)
Owner: --------- ------ – FEES --- -----
ROGER HAYS . . . ` .`' � type,;. amount by. .date recpt
12395 SW CORYLUS CT PRMT $ 25.50 JMH 01/27/97 97-289478
`~ '
. ,,� • .5PCT $ 1.28 JMH 01/27/97 97-289478
TIGARD OR 97223
Phone #: UNKNOWN
Contractor: – ------
B & T GAS SERVICE INC
TEASDALE,KEITH
8528 SW 190TH AVE
BEAVERTON OR 97007 . --
Phone #: 642-7243 $ 26.78 TOTAL
Reg #..: 000911
` ' REQUIRED INSPECTIONS
This.. permit is issued subject.. to regulations .contained,' in the Gas,. �Line .Insp • ' .
Tigard, Municipal Code, �tateo��r� Spec� an
Jty Codpsd�dl�thor.� Mechanical I nsp , • `.
applicable-laws, All..work in accordance with • Misc. •Inspection` • ' `
approved- plans. ,This permit , will expire if work -is not started. ^ ' ' , Final` Inspection
within 180 days of issuance, or if work' is- suspended for_ more. ' —
t 'Signature:
��
Issued B L'~���M�L^��' ~
^._ .; ' _._�_�' _ �_ ._�� _^ ^ , Call f or inspe�t 639,74175
- Plan Check #
CITY 0,,F- TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential • Date Rec'd
TIGARD, OR 97223 25// 0 -0 Date to P.E.
(503) 639 -4171, X304 Date to DST
Permit #
Print or Type Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code CITY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address / arfdo et:
B) Supplemental Permit 3.00
7 s 0 1 7,3a Y nnv (or name of busines 1.) Furnace to 100,000 BTU 6.00
Owner t l ,}' f ! Y l l CT in incl. ducts & vents
M . l. g Address J 2.) Furnace 100,000 BTU + 7.50
l �95 W � y/' incl. duds & vents
CLt e P Phone 3.) Floor Furnace 6.00
1 4 4, r/ oe I incl. vent
(•, * erne at /�� 4.) Suspended heater, wall heater 6.00
' 1 74P Al or floor mounted heater
Occupant Mailing; 'dry
-
5.) Vent not ind. in 3.00
/ ) ''r 96 iii i. i appliance permit
1 Ci tate a Phone 6.) Boiler or comp, heat pump, air cond. 6.00
'
Q, Q, SOP 97
N a m �, 7.) Boiler or comp, heat pump, air cond. 11.00
"
! - 1 60S 6 /Get 3-15 HP; absorp unit to 500K BTU
Contractor l in Address 8.) Boiler or comp, heat pump, air cond. 15.00
:D l< 61A) 9i� Alg--/ 15-30 HP; absorp unit .5-1 mil BTU
Attach copy of City/State ,[I ��' Phone l/ � 9.) Boiler or comp, heat pump, air cond. 22.50
Current. Licenses p11,0p/Thyd y7 6 7 - 7 �"7 30-50 HP; absorp unit 1 -1.75 mil BTU
Oregon Cont. Cont_ B Lic.# Exp e 10.) Boiler or comp, heat pump, air cond. 37.50
t , (� c l i >> 50 HP; absorp unit 1.75 mil BTU
• CO e,) I 11.) Air handling unit to 4.50
10,000 CFM
Architect Name ^ !� � /h 7 I 7"
12.) Air handling unit 7.50
10,000 CTM +
or Mailing Address 13.) Non portable 4.50
evaporate cooler
Engineer ceyyrstate Zip Phone 14.) Vent fan connected 3.00
to a single duct
1 Describe work New 0 Addition 0 Alteration epai 0 . 15.) Ventilation system not 4.50
to be done Residential A -�Flon residential O included in appliance permit
Additional Description of work 16.) Hood served by
,, q$ & mechanical exhaust 4.50
L . � f /� ' 17) Domestic incinerators 7.50
ll
1 Existing use of 18.) Commercial or industrial 30.00
building or property type incinerator
1 19.) Clothes dryers, etc. 4.50
i P2 a # .
Proposed use of 20) Other units 4.50 1„,
building or property s. G . 6 - 2 {/V" ► - I � h �
Type of fuel - oil 0 natural gasG 0 electric 0 21) Gas piping one to four outlets / 2.00 l� a
I hereby acknowledge that I have read this application, that the 22) More than 4-per outlet (each) .50 <73
information given is correct, that I am the owner or authorized agent of d
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL x4,, ;' ° ;B
S re OwnerfAgent Date *SUBTOTA . t
U y � /_ z , __ F, 5% SURCHARGE ''"
Conta Per son Name Phone PLAN REVIEW 25% OF SUBTOTAL 'r `"
TOTAL ' . .�,.. : it
eldst4nechpmtdoc `Minimum permit fee is $25 +5% surcharge _ �
Rev 7/96 - - o'°t'i 7
174 aize ec
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing (
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
r
Other: ti ■ I , i
�r .�. Jr
Date: , a- A.M. P.M. Eitry:
Address: C s� ✓ /
Tenant: Ste: MST:
BUP: _
Con /Own: MEC: w it ' — O
PLM: Z ! f
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
Inspectol Date:
b DISAPPROVED /CALL FOR REINSP. CF CO
CITY OF TIGARD BUILDING INSPECTION DIVISION - MST
24 -Hour Inspection Line: 639 -4175 Business Li� 639 -4171
BUP
Date Requested 12-7 AM PM gL
Location ) 2-? cic CD( 1� Suite q C' . t r =C n �(p,I
Contact Person g Y/( (? Ph 5 37 - &7 / 0 PLM t 1
Contractor Ph SWR I _
BUILDING - ; Tenant/Owner ELC r
Retaining Wall ELR
Footing Access: •
Foundation '�` ---- FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab
Post & Beam y i — / ; 1 , 00- ..C1V5)
Ext Sheath /Shear ���
Ina ming /Shear i it /�� i._�/\ /r
Framing (i jl V I 7c--,-L. LR ■ � �-
In
D sulation `� , ..-.D C� n , ` � ' < G(
Drywall Nailing � v � � 't
Firewall J •
Fire Sprinkler �\ S �--+�1 t, Q S C,
Fire Alarm J
Susp'd Ceiling A-C■e
LA-11,<.(A •
Roof
Misc: I AAA .6 "\ al2-4.-r6..-A. c,e A
Final C v V A9tAx \--e 5 �. 5 '. ....k c .''��
PASS PART FAIL
PLUMBING ^4A - , - /k •
Post & Beam �� ((�1 _
Under Slab J '"t � -e— ` -'fC.-c—e_ ?�S v\-) Ci. j
Top Out
Water Service
Sanitary Sewer
Rain Drains p� 1
Final
PASS PART FAI ■ I I ADC V 06 p i V'�Q `�`t- c—e.... \re...A
7 CHANI ' i 1 '' --^
Post & Beam 't. - - 11�
Rough In v"• ` CC _. z -- 0 C O6 4 .
Gas Line ,, ' Q
S oke Dampers C pL ✓ �✓`
PA PART FAIL Y �
RICAL �
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final r
PASS PART FAIL � l
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 � /f . Aproach /Sidewalk Date 1. .1 vt, v ( C) b Inspector ` Ex
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.