Permit .'`' `' CITY OF T MECHAN I CAL
��H�, DEVE LOPMENT SERVICES PERMIT
p � � Ii PERMIT # : MEC99 -01 �6
= 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03; 25 / 99
PARCEL: 2S115BC- 05200
SITE ADDRESS...: 16545 SW KING CHARLES AVE
SUBDIVISION • ZONING:
BLOCK...... • LOT • JURISDICTION: KIN
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/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 UN,I TS • . AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 1.00K BTU: 1 <2 10000 cfm: 0 GAS OUTLETS.: 1
FURN >2100K BTU: 0 > 10000 cfm: 0
Remarks : Installation of gas furnace and gas piping.
Owner: FEES
HERBERT SEIDEL type amount by date rec.pt
16545 SW KING CHARLES PRMT $ E5.00 DEB 03/25/99 KING CITY
KING CITY OR 97224 5PCT $ 1.25 DEB 03/25/99 KING CITY
Phone #:
Contractor:
BRUTON COMFORT CONTROL INC
_. 12855 SW 22ND ST
$ 26.25 TOTAL
BEAVERTON OR 97008 -5152
Phone #: 503 -626 -7477
Reg #..: 65296 .
REQUIRED INSPECTIONS
This persit 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 Lint Insp
approved plans. This persit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for sore
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 say
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue y: ,� 'Y1ti'Q Permit Signature: / . Iii', L f l
+++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + +..
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
LIAR- 25 —'99 THU 10:07 ID: FAX NO: r 14084 P02
RECEIVED Plan Check # l P_„0
CITY OF TIGARD Mechanical Permit Application Rec'd By 3 - s 51
13125 SW HALL BLVD- MAR 2 5 199tommercial and Residential Date Rec'd
TIGARD, OR 97223 . Date to P.E.
(503) 639 -4171, x304 COMMUNITY DEVELOPMENT Date to DST .5—.9---5
Print or Type Permit#
Called
Incom•lete or illegible applications will not be accepted -
Name of bevelapmentiProJect Description
Table 1A Mechanical Code Qty Price Amt
A) Permit Fee StreetMoress suttaa %.q,,KT.i.: 10.00
1.;;,.;., sc %,:.:.
Job � 1) Furnace to 100,000 BTU
Address J c L9 h►3y ' 0. including ducts & vents 6.00
eldgir thy /State Zip 2) Furnace 100,000 BTU'r
C•77q LI including ducts & vents 7,50
— Name (or name or business) 3) Floor Furnace
including vent 6.00
Owner j3 • ‘"9 S 6) PO?) 4) Suspended heater, wail heater
enailinp Address or floor mounted heater 6.00
I. (S 9s- 5%--, '.,\,t C...A(41> 5) vent not included In appliance permit
city /Slate Zip Phone 3.00
y, � CHECK ALL "Boiler Heat ' Air
i`e `vi. r THAT APPLY: or Pump Cond Qty Price Amt
Nam (or nettle of business) Comp "*
• 6) <3HP;absorb unit to •
Occupant Mailing Address • 100K BTU 6.00
7) 3 -15 HP; absorb unit
City /Stale Zip ' Phone .100K to 500k BTU — 11.00 _ __
8) 15 -30 HP; absorb
unit .5 - mil BTU 15,00
Contractor Name 9) 30 -50 HP; absorb
� bJ 7010 (Di l„fr (' ani(CO L unit 1 -1.75 mil BTU 22.50
Prior to permit u� ailme Address 10) >59HP; absorb unit
Issuance, s copy , t 2 QtcS- - S"- .2 q-- S I • 71.75 mil BTU 37.50
et all licenses cit Zip Phone 11) Air handling unit to 10.000 CFM
%
are required if i,...e7s i 4 f 70th. 1 i2b -7Y ?7 4
expired in COT Oregon tonal. Cons. Board (Jc.0 exp. Date 12) Air handling unit 10,000 CFM+
databacn c, , ' 7.50
Architect Nam° 13) Non - Aorta• a evaporate cooler
4.50
Mailing Address - 14) Vent fan connected to a single duct
M
or 3.00
15) Ventilation system not included in
Engineer crtwstate • Zip Phone appliancepermit 4.50
16) Hood served by mechanical exhaust
4.50
Describe work to be done: 17) Domestic incinerators
7.50
• New 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator
I�gsidential>� Commercial 0 30,00
Additional Information or description of work: 19) Repair units
4.50
20) Wood stove 4.50
21) Clothes dryer, etc,
• 4.50
1ype of fuel: oil 0 ' natural gas tE1 LPG 0 electric 0 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 A -per outlet (each)
50
Signature or Owner /Agent Pete : %A''` g:^ ;ii;, M; ; , r ;'4i. c ®
Minimum Permit Fee $25.00 SUBTOTAL , IV:. , :: 1 is,: ..: S ,
_ ✓ ? / ! a ,i f � _ cat, cunci Ir,ncc ins iu;A�JJ,':•, A„r,^I ?- 4. as-- Conta Pe Name Phone PLAN REVIEW 25% OF SUBTOTAL l.%f-'%;`z -r r'i
Re • utred for ALL commercial permits ` '"
only ' .., :r . i . 1- . - ~ ;7 ,-'
T OTAL ifi:' ': ;i LS
• MVl1 �i MO.) Gr7N, 2D� J��y ` ;r`' , ! 4 ; , ,; o
- - -- *State Certification required
**Residential A/C requires site plan showing placement of unit
is rnechperm.doc rev 07/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested L I S-9 q AM PM BLD
h
Location t(0,-/ J C/y1 .,,p ° mi l. Suite MEC qq / 2 - (j
•
Contact Person J i' 01/q Ph IA' - 374-i 3 PLM f rig - OYO
Contractor Ph SWR
BUILDING' :i : : a ` 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
i .JIllliril :11 _: _- :4, a .
Post & Beam
Under Slab
le 1 Top Out
Water Service
Sanitary Sewer
Drains
PART FAIL
r C,HANICAA + L :
..4.
•'°� - • BL dII I
Rough I
Gas Line
/ Ago l/WDf Z ampers
PART FAIL
'ELECTRICAL 414'4:4 '
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE4 4:
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 V i -1` f �r �
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.