Permit CITY OF TIGARD
„, N DEVELOPMENT SERVICES MECHANICAL
PE.RMIT
=.'! -- 1 3125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171. PERMIT #.......: MEC99 -0034
DATE ISSUED: 01/25/99
PARCEL: 2S1O3CB -00400
SITE ADDRESS...: 12165 SW JAMES ST
SUBDIVISION. . a .: WILLAMETTE Z ON I NG : R-4.5
BLOCK........... LOT..,.... — — ..:006 JURISDICTION: URB
CLASS OF WORK.. : OTR 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
3 -15 HP....: 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP....: 0 REPAIR UN I. TS : 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 < 1OOK BTU: 1 (= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Replace existing oil furnace to gas furnace and add gas line.
Owner: _.._._.._.___.__ ____ -_ FEES
MERLE STAEHNKE type amount by date recpt
12165 SW JAMES ROAD PRMT $ 25.00 GEO 01/25/99 99- 312394
TIGARD OR 97223 5PCT $ 1.25 GEO 01/25/99 99- 312394
Phone #:
Contractor : - ---
SPECIALTY HEATING & FABRICATIO
9528 SW TIGARD ST ___-- -.._ -. ----- _ -__-
26. 25 TOTAL
TIGARD OR 9722.E
Phone #: 620-5643
Reg #..:. 006657
-------- 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 Heating Un t 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 mare _ ___ —.__ _ _____
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 -001 -0080. You may __�__ ___ _� ,_
obtain copies of these rules or direct questions to OUNC by calling — _
(503)246 -9187.
Issue By: , _ - 1"ermittee Signature _ _ _
+ + + + + + ++ + + + + + + + ++ 1-++++++±+++++++++++++++++• f-++ ÷+++ + ++++ ++ + + + + + + +++ ++ + +4•+++ + + ++ ++
Call 639-4175 by 7:00 p.m. for inspections needed the net business day
+ + ++ + +- ++++±+++++++++++++++++++++ + + + + + +++ + ++ + ++++ +++ ++ + + + + + + + +•i +++ + ++ + + ++ + + ++ ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
a (503) 639 -4171, x304 fP Date to DST
Print or Type Permit # �(' 4'9 4'3/
Incomplete or illegible applications will not a accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address Q � Suite# A) Permit Fee " �; * 10.00
Address /al65 5) JCt, i'L £L 1) Furnace to 100,000 BTU 1 including ducts & vents 6.00
Bldg# City /State Zip 2) Fumace 100,000 BTU+
I 1 l ayc X 7 3 including ducts & vents 7.50
Name (or name of business) 3) Floor Furnace
owner 4e S -ekvt -14- including vent , 6.00
Mailing Address 4) Suspended heater, wall heater
Ir
or floor mounted heater 6.00
/a2( 1,5 50 aL1 5 5) Vent not included in appliance permit
City/State �/ Zip Phone 3.00
I L yL(d_ v1' 9 '70 40 - 342q CHECK ALL *Boiler Heat Air
Name (or name of business) THAT APPLY: or Pump Cond Qty Price Amt
5 ,V111 °. Comp
6) <3HP;absorb unit to
Occupant Mailing Address 100K BTU 6.00
7) 3 -15 HP;absorb unit
City /State Zip Phone 100k to 500k BTU 11.00
8) 15 -30 HP; absorb .
Contractor Name unit .5-1 mil BTU 15.00
S nee,
9) 30 -50 HP; absorb
^ f L 1 J I 'j n �� - l
I " ULu " Ct es.t} unit 1 -1.75 mil BTU 22.50
Prior to permit Mailing Address 10) >50HP; absorb unit .
issuance, a copy S 1.() 1 Lla-li '� • >1.75, mil BTU 37.50
of all licenses City /State J Zip Phone 11) Air handling unit to 10,000 CFM
are required if l (. Qrd. 6b& 4 7 6.20 - 560j 4.50
expired in COT Ore. • Const. Cont. ; Exp. . gate �� 1 12) Air handling unit 10,000 CFM+
database "' x.� fit
Architect Name 13) Non- portable evaporate cooler
4.50
or
Mailing Address 14) Vent fan connected to a single duct
3.00
15) Ventilation system not included in
Engineer City/State Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust •
Describe work to be done: 4.50
/ 17) Domestic incinerators
New Ql Rep air O Replace with like kind: Yes 0 No i 7.50
Residential 9/ Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
Ft (2a_ ! Vt.5 - ta � t r /y 6i( • 1. h&'- c° ?YD UYI, 4.50
/ 20) Wood stove
6c! 9 CI-5 4.50
21) Clothes dryer, etc.
/ 4.50
Type of fuel: oil 0 natural gas Qr LPG 0 electric O 22) Other units
4.50
I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets
'
given is correct, that I am the owner or authorized agent of 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Signature of Owner /Agent Date , -,ir �
X� //25/q 9 Minimum Permit Fee $25.00 SUBTOTAL � ��
5% SURCHARGE ,.. •"; r
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL tU"
J 1 / dU / Required for ALL commercial permits onl v
• Shj ^ y�� v1 / uta-t h 5 4 -J6(3 TOTAL '
*State Contractor Boiler Certification required
**Residential A/C requires site plan showing placement of unit
I:\mechperm.doc rev 07/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION .
24 -Hour- Inspection Line: 639 -4175 Business Line: 639 -4171 °I ! MST
BUP
Date Requested I a' °I. t AM BLD
Location I 0-1.(n a � p— ,2,2_01 f Suite MEC `t 6 )
Contact Person A P-� Ph ,s-7,-)(43 PLM
Contractor Ph SWR
Tenant/Owner • ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain $GN
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
PASS PART FAIL
PLUMBIN
Post & Beam
Under Slab
Top Out
Water Service
Sanitary' Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL';
Post & Beam .
Rough In
Gas Line
Smoke Dampers
tgar
PASS -ART FAIL
- ICAL , u
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
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 , -- 17 7 7 Inspector Ext
Final
PASS PART FAIL .DO NOT REMOVE this inspection record from the job site..