Permit �� CITY OF TIGARD
MECHANICAL PERMIT
PERMIT #: MEC1999 -00436
111 DEVELOPMENT H B Tigard, ) 6 39 -4171 DATE ISSUED: 10/14/99
OR
PARCEL: 1S134CD-03600
SITE ADDRESS: 11950 SW KATHERINE ST
SUBDIVISION: LERON HEIGHTS NO.3 ZONING: R -4.5
/e //1/ BLOCK: LOT: 063 e JURISDICTION: TIG
LO 4 . CLASS OF WORK: OTR 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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Remarks: Installation of gas piping.
Owner: FEES
FRANK BACCELLIER Type By Date Amount Receipt
11950 SW KATHERINE ST PRMT DEB 10/14/99 •$50.00 99- 319092
TIGARD, OR 97223 SPOT DEB 10/14/99 $4.00 99- 319092
Total $54.00
Phone: 579 -2015
Contractor:
HOLMES INSTALLATION SERVICE •
RAYMOND FLANDERS
33535 NW VADIS ROAD REQUIRED INSPECTIONS
CORNELIUS, OR 97113 Gas Line Insp
Phone: 647 -9320 Final Inspection
Reg #: LIC 00102473
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 rgtlsa -1 0 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Ilit_y Notification Qenter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
ou may obtain copes of jes roles or •irect questions to OUNC - -- calling (503)246 -9189. -
sue By:�� , � � ,d_ Permittee Signature: ,���(�„
Call (503) -39 -4175 by 7:00 P.M. for inspections needed the next business day
\. Plan Cluck #1
CITY`;OF TIGARD Mechanical Permit Application Recd j94
13125 SW HALL BLVD. Commercial and Residential Date Recd /o -- (9
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit - fr
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 "° 16.00
Address ,l cQ S I✓✓ gii/c"te 1) Furnace to 100,000 BTU
. including ducts & vents see footnote 1,2 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
7 f6cL i gt including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner -� k a a 6-c 4 4/ e f` including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
?-- or floor mounted heater footnote 1 ,2 9.65
i'? 0 i,/ 1 1(4 re/4" t ~� 5) Vent not included in appliance permit see 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
r i k PE it 77/ _h l5 For items 6 -10, see or Pump Cond Qty Price Amt
Names (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 • 100k to 500k BTU • 17.65
-
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Contractor Name unto absorb
1-1.75 mil BTU 36.00
I/omin< 1 /v$ ¢(/ .ce t/i Ge 10 >50HP; absorb unit
Prior to permit Mailing dre C , /) / >1.75 mil BTU 60.15
U
issuance, a copy �j ,5 �
3 s / 1/a f S /'CLt 11 Air handling unit to 10,000 CFM
of all licenses City /State Zip .69.7-9.12o Phone 7.00
•
are required if C 1 1/
% . �'7 "OS 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board,Lic.# Exp. Date 11.85
database 102.9 73 j0 '-- £ ' 13) Non - portable evaporate cooler •
Architect Name 7.00
14) Vent fan connected to a single duct
4.75
or Mailing Address
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
New Repair 0 Replace with like kind: Yes O No O 18) Commercial or industrial type incinerator
Residential sit Commercial 0 48.25
19) Repair units
Additional information or description of work: 8.40
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 7�
structural gas talcs. 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 INY, ''°` o D
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE ' ' ,'' . e
given is correct, that I am the - owner or authorized agent of PLAN REVIEW -25% OF SUBTOTAL , &,z,,,, ' @ r2 PiPes
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only;_��
P P 9 TOTAL ,:::;1-: . ., ..,. / 61
• Si ture of Owner /Agent ontact Person Date Q . ° _ (f`'
s on Name Pho ne to - */ l
1. Inspections outside of normal business hours (mininum charge -two
' 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) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. *State Contractor Boiler Certification required
. * *Residential A/C requires site plan showing placement of unit
I:\mechperm.doc rev 7/19/99 _,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Date Requested // AM PM BLD
Location J l d 7 � --+ �� S*Suite MEC (1? 9 00 7-'3
Contact Person Ph S7 9 PLM
Contractor Ph SWR
BUILDING`: Tenant/Owner ELC
Retaining Wall _ ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING ''£ ` e$
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
PART FAIL
ELECTRICAL rt. ` - a :`,¢ .
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL 1/4
SITE:'. j
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
Approach /Sidewalk other Date C 15 lq Inspector �� Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •