Permit CITY OF T I G A R D MECHANICAL.
�4.il� )\ DEVELOPMENT SERVICES PERMIT
�!�o!�l��l�j �.. n ... e :
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT MEC98-- 0406 DATE ISSUED: 09/16/98
PARCEL..: 2S 1 1 !Z!CC -14500
SITE ADDRESS...: 12327 SW KING GEORGE DR
SUBDIVISION....: KING CITY NO 5 ZONING:
BLOCK.a...eo.,. o LOT.od..00a...a.. :015 JURISDICTION: KIN
CLASS OF WORK. . :OTR FLOOR FURN..> : !Z! EVAP COOLERS: 0
TYPE OF USE.... :SF UNIT HEATERS...: O VENT FANS...: 0
OCCUPANCY GRP.. :R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES. D o e ....: 0 BOILERS /COMPRESSORS HOODS. n a n o< a: ►Z!
FUEL TYPES -- - -__ --- 0 -3 HPe .. e : 1 DOMES. INCIN: 0
: GAS 3 -15 HP....: O COMML. I NC I N: 0
MAX INPUT: 0 BTU 15 -30 HP. „ ..: !Z! REPAIR UNITS: 0
FIRE DAMPERS?. a : ' 30-50 HP. o . n : 0 WOODSTOVES. , : 0
GAS PRESSURE... 50+ HP„ .. „ : 0 CLO DRYERS, a : 0
NO. OF UNITS----- AIR HANDLING UNITS OTHER UNITS. : 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
TURN > =100K BTU: 0 > 10000 cfm: 0 •
Remarks : Installation of furnace, heat pump & gas piping. Conversion froo •
electric to gas.
Owner: --. .-
IVAN CLARK type amount by date recpt
12327 SW KING GEORGE PRMT $ 25.00 DEB 09/16/98 KING CITY
KING CITY OR 97224 5PCT $ 1.25 DEB 09/16/98 KING CITY
Phone #:
Contract or: _- -------------
ENERGY MASTERS HEATING & A/C
7470 SW 76TH _ _____ --
$ 26.25 TOTAL
PORTLAND OR 97224
Phone #: 244 -8880
Reg #o n : 000585
— - REQUIRED INSPECTIONS
This peroit 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 Heating Unt Insp _,
approved plans. This peroit will expire if work is not started Cooling Unt Insp _
within 188 days of issuance, or if work is suspended for more Final Inspection
than 188-days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 - 801 -0I1Q! through OAR 952 -N1 -088. You nay _
obtain copies of these rules or direct questions to OUNC by calling
' (N3)246-9187.
Issue By: PerYmittee Signature: - _
+++++++-+-++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for inspections needed the next business day
+ + + + + + ++ ++ ++ + + + + +++ + + + +-i ++++++++++++++++++++++++++ + + + + + + + + ++ + + + + ++ ++ + + +•+• + + + + + ++
EP- 16 — '98 THU 09:58 ID: FAX NO: #053 PO3
Plan Chec .
CITY OF TIGARD Mechanical Permit Application aeotl ey
13125 SW HALL BLVD. Commercial and Residential Date Recd 9 - /4-Z
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to OST
Print or Type Permit#
Incomplete or illegible applications will not be accepted Called
Name of pevetopmeni/Proje �,r Description
I V AL) CC. -Pile Table 1A Mechanical Code Q Price Amt
Job Street Address Suits/ A) Permit Fee ....:;.:::,.....,.,....:::::.,".•.: 10,00
Address 1 C,W , CIS YeOZ64.. 1) Furnace to 100,000 BTU
including ducts a vents 6.00
Bldg* city/state Zip 2) Furnace 100,000 BTU+
including ducts & vents 7.50
Name (or name of businaas) 3) Floor Furnace
Owner I U > C LP Q Including vent 6.00
Marring peeress 4) Suspended heater, wall heater
,2 3�� S K. { �+L GC $� v nt not heater 8.00
5) Vent not included in appliance permit -
City /State • Zip Phone 3.00
(� G g77-2€ (,61-745 CHECK ALL `Boiler bleat Air
Name (or name of business) THAT APPLY: or Pump Cond Qty Price Amt
Come "'
6) <3HP ;absorb unit to
Occupant Mailing Address 100K BTU 1/".' 6.00
7) 3 -15 HP;absorb unit
City /State Zip Phone , 100k to 500k BTU 11.00
8) 15 - 30 HP; absorb
'
— • unit .5 -1 mil BTU 15.00
Contractor Name
i 4 M i cy / UG 9) 30 -50 HP; absorb
0 ,
Mr's" J '"� r unit 1-1.75 mil BTU 22.50
Prior to permit Mailing Addroae 10) >50HP; absorb unit
issuance, a copy 70 S - ,Ctt k 1(„, 114 71.75 mil BTU 37.50
or all licenses Oily/State Zio ' Prone 11) Air handling Unit to 10,000 GFM
are required if pr(..(�, OR, q -)37 -3 244. . 8O 4.50 ,
expired in COT Oregon C C rd Llclr p. Dale 12) Air handling unit 10,000 CFM.
database 0s6't la�o t 5 -4' 7.50
Architect Name V 13) Non - portable evaporate cooler
4.50
or
Mailing Address 1d) Vent fan, connected to a single duct
3,00 ,
15) ventilation system not included•in
Engineer City /State Zip Phone appliance permit • 4.50
16) Hood served by mechanical exhaust
•
Describe work to be done: . 4,50
17) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes.No O .. 7.50
ResldentielC Commercial 0 •18) Commercial or industrial type incinerator
•
— 30.00
Additional information or description of work: 4 ., . W ` .' 1 Repair units 4.50
' (_ a r C (Ste 20) Wood stove .
�'� C0-0Th I t - 4.50
' 21) Clothes dryer, etc.
4.50 .
Type of fuel: oil 0 natural gas$ LPG 0 electrk ' 22) Other units
„ 4.50 _
- I hereby acknowledge that I have read this application, that the information . 23) Gas piping one to four outlets QO
given is correct, that I am the owner or authorized agent of i 2.00 ( 9.'
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
SI . : Lure of Owner/ . ent Date ;;;:.•,;:-,:.. T;s
Oj / Ste, ( .4 6, 66 Minimum Permit Fee S7g.00 SUBTOTAL "' v ,0 ,
"" 4 :. ; .` • , , • ,., :, ; :: ,,`
5% SURCHARGE f :Yi_.t:; ; : w - i f ' •
Contact Pe-- on Name Phone PLAN REVIEW 25% OF SUBTOTAL 1„ ; ,, ,;
' - tv=1-1 ee Jew, -2-,f4-13866 Required for ALL commercial permits only
TOTAL �":i 3 i
"State Boiler Certification required
"Residential A/C requires site plan showing placement of unit
Llmechperm.doc rev 07/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
ST
2 p l BUP
ZJ / I /5 3 Date Requested - 1 - a l " 9 Q AM )c PM BLD
Location 1 2- 32 7 SW 1 1 t DJ, Suite 400 (7 -0 4l 6
Contact Person '' Ph PLM
""
Contractor vYL _U ,44CL4WL(Z ) Ph N L - SWR
BUILDING° Tenant/Owner • ELC
Retaining Wall ELR •
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab Q p� (� SIT
Post &Beam d‘to f 9,,� c /. D D 7 T f( 'i h Ext Sheath /Shear ` vv
Int Sheath /Shear z
•
Framing
Insulation
Drywall Nailing A 'ZAI4Cc�
Firewall
Fire Sprinkler 6 As cp,7, n_e �,T, Tz✓ = 20 j ' s �.� �� /,,t2ii�v'TL�
Fire Alarm
Susp'd Ceiling C -774 -S -A' 3/28
Roof
Misc: Nc C4 s o iV
Final
PASS PART FAIL 0 . j s `J ( )
PLUMBING" _ ;
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
•
Post & Beam
t; Rou h I �L
as crAS
Smoke Dampers c
in /
PASS) PART FAIL
ELECTRICAL } w' -. r M
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 _ — -- - - - — -- Other
oach /Sidewalk Date I2® c' Inspector Ext
Z
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.