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Permit
r. CITY OF T MECHANICAL A DEVELOPMENT SERVICES PERMIT • :VW 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE PERMIT ISSUED: . 08/ 19 / 988 -1 00 PARCEL: 2S112CB -07600 SITE ADDRESS...: 15165 SW KENTON DR SUBDIVISION - ASHFORD OAKS NO. 2 ZONING: R -7 PD BLOCK........... LOT.... ....... ..:090 JURISDICTION:.TIG CLASS OF WORK..:ADD 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 - 0 BOILERS /COMPRESSORS HOODS.......: 0 FUEL TYPES 0 -3 HP - 0 DOMES. INCIN: 0 :GAS 3 -15 HP - 0 COMML. INCIN: 0 MAX INPUT: 0 BTU 15 -30 HP....: 0 REPAIR UNITS: 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.: 1 FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1 FURN 7 =100K BTU: 0 } 10000 cfm: 0 Remarks: Gas fireplace Owner: FEES GINA CASPER type amount by date recpt 15165 SW KENTON PRMT $ 25.00 B 08/14/98 98-308273 TIGARD OR 97224 5PCT $ 1.25 B 08/14/98 98- 308273 Phone #: Contractor: JAY'S GAS PIPING PO BOX 793 $ 26.25 TOTAL_ BEAVERCREEK OR 97004 Phone #: 632 -8623 Reg #..: 011983 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 Mechanical 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 more __,_ 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- 'A1- 0080.. You may - obtain copies of these rules or direct questions to OUNC by calling (503)246 -9187. II Issue By: �—'' Per m ittee Signature:(/\ / / , �_ -_ / ' B • + +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7;00 p.m. for inspections needed the next business day + +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Plan Check # CITY OF TIGARD Mechanical Permit Application Rec'd By "13125 SW HALL BLVD. Commercial and Residential Date Rec'd P /iv /gR TIGARD, OR 97223 Date to P.E. Rai (503) 639 -4171, x304 Date to DST (.f/\ Print or Type Permit# MEc98- Joao Incomplete or illegible applications will not be accepted Called Name of Development/Project Description Table 1A Mechanical Code Qty Price Amt . Job Street Address r Suite# A) Permit Fee , " 10.00 Address /51 oS S'(.J KE►J T ary 1) Furnace to 100,000 BTU . including ducts & vents 6.00 Bldg# City /State Zip 2) Furnace 100,000 BTU+ including ducts & vents 7.50 Name (or name of business) 3) Floor Furnace ... Owner including vent 6.00 Md; g Address 4) Suspended heater, wall heater or floor mounted heater 6.00 kS SW . < ( Dr< ' 5) Vent not included in appliance permit City /State Zip Phone 3.00 N ame a - �o �Z1 CHECK ALL *Boiler Heat Air Nam of THAT APPLY: or Pump Cond Qty Price Amt Comp • Occupant Mailing Address 6) <3HP;absorb unit to OCCU P 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 unit .5 -1 mil BTU 15.00 Contractor Name � 9) 30 -50 HP; absorb `► � T5J - �j\ unit 1-1.75 mil BTU 22.50 Prior to permit mg Addrss I\ 10) >50HP; absorb unit issuance, a copy tr0 ( .0.-C. .- _ - • �Q OOO»> >1.75 mil BTU 37.50 • of all licenses City /State 4X 't,(�6}LZip Phone 11) Air handling unit to 10,000 CFM are required if �V €Q CQC' . ‘5.1.1 2- 4.50 expired in COT Oregon Con Cont. Board Lic.# Exp. Date • 12) Air handling unit 10;000 CFM+ database - S \� NCO ^2ct - R 7.50 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 0 Repair 0 . Replace with like kind: Yes 0 No 0 7.50 Residential* Commercial 0 18) Commercial or industrial type incinerator • 30.00 Additional information or description of work: , • 19) Repair units ht (c a\ � k ,_. ` 20) Wood stove 4.50 K 4.50 ` Q � b (�Q@ t k" 4_cy.9-Q� .0 o.. 21) Clothes dryer, etc. v ``�� 4.50 Type of fuel: oil 0 natural gas' LPG 0 electric 0 22) Other units Gi1-s t iL.t P(A-CG / 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 Oregon State laws. 24) More than 4 -per outlet (each) .50 • Signature of Owner /Agent Date 0 Minimum Permit Fee $25.00 SUBTOTAL 015/ 5% SURCHARGE >` ;\ 7:„.... /` Con��Person Name Phone PLAN REVIEW 25% OF SUBTOTAL Required - for-ALL commercial - permits only —$I , . - s (, co LO '�21U TOTAL SD. *State Contractor Boiler Certification required (P �� * *Residential NC requires site plan showing placement of unit I:\mechperm.doc rev 07/20/98 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24- our Inspection Line: 639 -4175 Business Line: 639 -4171 (25 , 0 ! p� BUP Y / Date Requested r — q6 ,,,� AM PM BLD Location 15/675 SW dVAIY-M Oal Suite j C —• /0 ©Q Contact Person / Ph � PLM Contractor Ph (94 oq -i1 .77 SWR BUILDING_ , ,,`r . ` .. „ -, Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: SGN Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear - rr Framing C..:1 S 4 31/ 0 0 7 Insulation J Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL Er (7d. )T . : PLUMBING d :,,:1,,,t? _''' Post & Beam C. Under Slab Top Out Water Service /3__ Sanitary Sewer Q...7 Rain Drains Final PASS PART FAIL iVIECHANICAL .'fr: .<: :'' -''H Post &Beam I L ou hln s , I L(110/ In Smoke Dampers PART FAIL _ ELECTRICAL ': :- _ :y, . Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE' -_` n;7F._gs4Pi_o,' `.'' . 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 D ate fJ/ 2 " (P. 9 T) Inspector Ext l Final PASS PART FAIL DO NOT REMOVE this inspection record from. the job site.