Permit CITY OF TIGARD
MECHANICAL PERMIT
Ali DEVELOPMENT SERVICES PERMIT #: MEC2000 -00245
a I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/19/2000
PARCEL: 1 S134AC -01000
SITE ADDRESS: 11406 SW IRONWOOD LP
SUBDIVISION: ENGLEWOOD ZONING: R - 4.5
BLOCK: LOT: 038 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: 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Install new gas furnace, gas line and air conditioning unit. A/C units cannot be placed within the required
setback areas.
Owner: FEES
PFALLER, KELLY J /JANETTE L Type By Date Amount Receipt
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11406 SW IRONWOOD LOOP PRMT GEO 06/19/20C $50.00 0003098
TIGARD, OR 97223 5PCT GEO 06/19/20C $4.00 0003098
Total $54.00
Phone:
Contractor:
ROTH HEATING -'-
ROTH ZACHERY HEATING INC
PO BOX 1265 REQUIRED INSPECTIONS
CANBY, OR 97013 Gas Line lnsp
Phone: 503 - 266 -1249 Heating Unt lnsp
Reg #: LIC 00014008 Cooling Unt Insp
Final Inspection
ORIGINAL
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -00 0 through OA 952 - 001 -0080.
You may obtain copies o trese rules or direct questions to OUNC by c ling ( 3)246- 189.
Issue By: • 4110:0L _ Permittee Signature: (ti
Call (503) 639 -4175 by 7:00 P.M. for inspections needed then xt busines day
Received: 6/15/00 17:01; 503 598 1960 -> ROTH HEATING & A /C; Page 1
06/15/00 THU 16:22 FAX 503 598 1960 CITY OF TIGARD 8001
CITY OF TIGARD Mechanical Permit Application Plan Ch #
Rec'd By _
13125 SW HALL BLVD. Commercial and Residential Date Rec'd
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TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 C> C0 e
Date to DST
Print or Type
Permit # /vt°at 60,24/$'
Incomplete or illegible applications.will not be accepted Called
Name of Developm tt/Proiect Description .
'ell PPA(Le< Table 1A Mechanical Code . Qty Price A) . Amt
16.00
Job Street A ess Suite# 1) Permit Fee Furnace to 1 00,000 BTU
Address If V!� S /, �,/ J(v,, , including ducts & vents . see footnote 1,2 1 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+ •
y „ n4 q 7Z6 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner 6 C 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
5) Vent not included in appliance permit 4.75
City /State Zip - Phone Check all that apply: Boiler Heat Air .
D _CR(12 For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
Set 6 6) <3HP;absorb unit to
100K BTU I • 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5-1 mil BTU 24.15
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9) 30 -50 HP; absorb
Contractor Name
,'// _ unit 1 -1.75 mil BTU 36.00
Tl-� f/A-/hih ( ooL 0■1 (.7 10) >50HP; absorb unit
Prior to permit Mailing Address � >1.75 mil BTU 60.15
issuance, a copy p-Q. � y / 1265 6---c) S S. A,s- fe
s1 / J 11 Air handling unit to 10,000 CFM
of all licenses ity /St n Zip Phone 7.00
are required if � ate » O t /7 /)73 266-(24, 12) Air handling unit 10,000 CFM+
expired in COT Oregon Caitst. Cont. Board Lic.# Ex . Date 11.85
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database I L ( C0: 4 - 13) Non - portable evaporate cooler
Architect Name 7.00
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14) Vent fan connected to a single duct .
M ailing Address 4.75
Or 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
Lt • 12.00
Newe Repair 0 Replace with like kind: Yes") No p 18) Commercial or industrial type incinerator
, Residential, Commercial 0 48.25 ,
• • 19) Repair units •
Additional information or description of work: 8.40
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20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00 .
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas caics. See footnote 1 3.75
Type of fuel: oil 0 natural gas tsz LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL `',' -•_' '� �°g: .
Y acknowledge that I have read this
hereb a application, '
PP lication, that the information 8% SURCHARGE �s` dS ; �' -S-,
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL 1 . = • �"
Required for ALL commercial permits ____ only �,•,� 1'lt
ommerc ' i
the owner, that plans submitted are 'n compliance with Oregon State laws. �, '
TOTAL **ION c c its
t
s+ >�Z
gnat r o f O ner gent Date = - 0,3 ,'i�7
_ Other Inspections and Fees:
(� / 1. Inspections outside of normal business hours (mininum charge -two
nta Perso Nam t D Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
Sor t 0 -C (, ( p 0 t i(QG - I NC) charge -half hour) $50.00 per hour
00 ot commercial projects only: 3. Additional plan review required by changes, additions or revisions to
Provide full schematic of existing and ro "osled pressure.
as line and plans (minimum charge- one -half hour) $50.00 per hour
9 P P 9 P
2. Provide drawings to scale showing existing and proposed mechanical
*State Contractor Boiler Certification required
units.
* *Residential NC requires site plan showing placement of unit
l:lmechperm.doc rev 7/19/99 .
I
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1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639-4175 Business Line: 639 -4171
BUP
D ate Requested l� o` g - AM PM BLD
Location //y v C T. c Le) e'f Suite MEC aeo ��d
Contact Person 5-e..e, Ph 6, // PLM
Contractor / Ph SWR
BUILDING`_ Tenant/Owner ��� V D4 5/Z_ ELC
Retaining Wall ELR
Footing da d
Foundation Access: F ( �� FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall �, y
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
r i
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ItilejlAWCAt
Post & Beam
Rough In
Gas Line
Smo Dampers
= PART FAIL
CTRICAL
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 ) Inspector g/1/ Ext "�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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