Permit CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC1999 -00399
`I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/23/1999
PARCEL: 2S111 BD -00100
SITE ADDRESS: 09780 SW INEZ ST
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -3.5
BLOCK: LOT: 036 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:
FURN <100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Gas fireplace insert & gas piping
Owner: FEES
CORA CORLISS Type By Date Amount Receipt
9780 SW INEZ PRMT BON 09/23/19c $50.00 99- 318553
TIGARD, OR 97224 5PCT BON 09/23/19. $3.50 99- 318553
Total $53.50
Phone: 503 - 639 -9630
Contractor:
COST PLUS HEATING + AIR '
7132 N FESSENDEN ST
PORTLAND, OR 97203 REQUIRED INSPECTIONS
Gas Line Insp .
Phone: 286 -2009 Misc. Inspection
Reg #: LIC 000479 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)246- 189.
Issue By: d----_/ Permittee Signature:
6(
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
CITY OF TIGARD Mechanical Permit Application
Plan Check
Recd By 0 i/
13125 SW HALL BLVD. • Commercial and Residential Date Recd 7 2-5-1
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST y�
Print or Type Permit# 4°R - 0&5
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 0.40.11; au : ` :° 16.00 AR
Address q.� so S <J 2re� 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
Owner C_:C V R_ Y (r.S 3 y am, C./Miss including vent see footnote 1,2 9.65
Mailing Address J 4) Suspended heater, wall heater
/� J�CC 1 e---- or floor mounted heater see footnote 1,2 9.65
"I �,S� 5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler. Heat Air
j[a- ro( q -+2 f- ( %3 For items 6 -10, see or Pump Cond Qty Price Amt
Nam (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
q 3-s Q 5.( .) ZD 1 e 104 to 500k BTU 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
Tga- -r j q-ZZCF unit .5 -1 mil BTU 24.15
N ame (X 9) 30 -50 HP; absorb
Contractor ,/ unit 1 -1.75 mil BTU 36.00
('fie ue ¶; 6'td VSO 17 10) >50HP; absorb unit
Prior to permit ma7 Address ,�, >1.75 mil BTU 60.15
issuance, a copy Fesepi e (7 11 Air handling unit to 10,000 CFM
of all licenses City /State �p Zip Phone �p 7.00
are required if p0 I'Q, nl T 9'ZU3 2 , -tom c / y(� .12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.85
database - �{ 9 Ma-3 n52601 13) Non - portable evaporate cooler
Architect Name ✓✓ / 7.00
4 dosr /u-c `74/?g 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
NewX Repair 0 Replace with like kind: Yes 0 No O 18) Commercial or industrial type incinerator
Residential'rk Commercial 0 48.25
19) Repair units •
Additional information or description of work: - 8.40
20) Wood stove /gas FP /other units /cloth dryer /etc. t
C rOtep Q -1 7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one tdfour outlets
structural gas calcs. See footnote 1 / 3.75
Type of fuel: oil 0 natural gas X LPG, O electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL ` " °4P'" 17. 5�
I hereby acknowledge that I have read this application, that the information 7% SURCHARGE 't � e 3
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL �.,�, ; +w=
Required for ALL commercial permits only i t °r
the owner, that plans submitted are in compliance with Oregon State laws.'` ` "'
P P 9 TOTAL " °•x s , , ; .-
Signature of Owner /Agent Date
&? � n Other Inspections and Fees:
Vd-V99 1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name hone hours) $50.00 per hour
. 2. Inspections for which no fee is specifically indicated (minimum
/n
CG' .5.- 993) 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 NC requires site plan showing placement of unit
. I: \mechperm.doc rev 7/19/99 ___`
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
( 47Z0 Suite AM PM BLD
Location "1 7 Ov Suite MEC I 1q9 -00 S9
Contact Person v Ph (DV- 9'' 30 PLM
Contractor Ph SWR
BUILDING #: it '' ` Tenant/Owner ELC
Retaining Wall ELR
Footing Access: -
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: C.JTe . SGN
Slab t� )4— SIT
Post & Beam
Ext Sheath /Shear c Y Y ►�,'�(..
Int Sheath /Shear
Framing
Insulation -
Drywall Nailing �( A Fire Sp )4 / �L 7'` d��
Fire Sprinkler gi2R � CJ '�'/
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 FAIL
,�i HANK
Post & Beam
o I
Gas ine
Smo e Dampers
• SS PART FAIL
EL TRICAL
Service
Rough In , r'
UG /Slab
••
Low Voltage O.
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 - ' Date D a Ins Ext
Other /
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site