Permit CITY TIGARD 0MECHANICALPERMIT
DEVELOPMENT SERVICES ✓ PERMIT #: MEC2000 -00005
I ll \I DATE ISSUED: 01/05/2000
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13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 \`�' PARCEL: 2S115BC 04900
SITE ADDRESS: 16500 SW KING CHARLES AVE
SUBDIVISION: ZONING:
BLOCK: LOT: JURISDICTION: KIN
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN <100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Move gas meter, permit is for additional gas piping. Previous permit had already benn finaled so could not add
to it.
Owner: FEES
IRENE GOLDSMITH Type By Date Amount Receipt
16500 SW KING CHARLES PRMT DST 01/05/20( $50.00 00- 320926
KING CITY, OR 97224 • SPOT DST 01/05/20( $4.00 00- 320926
Total $54.00
Phone: 503 - 598 -8558
Contractor:
JOHN P. GINTER MECHANICAL
2246 NE 217TH AVE
GRESHAM, OR 97030 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 849 -3647 Final Inspection
Reg #: LIC 135277
•
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 more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility tificatio Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You . ay obtain copes oft : - r les or direct questions t� OUNC by calling (,0 246 -9189.
Issu By: /J LEI Al .�'�j�f � � Permittee Signature: ,
Call (503 639 -4175 by 7:00 P.M. for inspections nee•!• the next busi ess day
' Plan Ch
CITY OF TIGARD Mechanical Permit Application Rec'd By k#
e3125tSW HALL BLVD. Commercial and Residential Date Rec'd /
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
` 1
Print Permit # �-.
rint or Type
• Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
v2 2 Table 1A Mechanical Code Qty Price Amt
� 1 �'S �' ^ A) Permit Fee NAlti ,:r 16.00
J Street Address uite#
/��
Address 1 560 $ .0. F tkq C�„� 1) i nclud i ng ducts & vents see footnote 1,2 9.65
Bldg# City/Safe Zip 2) Furnace 100,000 BTU+
•
k; e t 6- 47ia 1/ including ducts & vents see footnote 1,2 12.00
Name (or name of business) --4 � ) 1/ 3) Floor Furnace
Owner 1 t including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 9.65
5) Vent not included in appliance permit 4.75
City/state Zip Phone Check all that apply: *Boiler Heat Air
• For items 6 -10, see or Pump Cond Qty Price Amt
Name (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
9) 30 -50 HP; absorb
Contractor Name
/+ ` + ' unit 1 -1.75 mil BTU 36.00
VJi T la e ✓- <C- a.K 1 c 2 / 10) >50HP; absorb unit .
Prior to permit Mailing Address , F � >1.75 mil BTU 60.15
issuance, a copy a A q 6 N. ( 00 _ 1 pi 1 A. A.) Q. 11 Air handling unit to 10,000 CFM
of all licenses a /Sta e5 M A y_ D if Zip Phone 7.00
are required if J 77636 612 7 1 12) Air handling unit 10,000 CFM+ .
expired in COT Oreg Const. Cont. Board Lic.# E x . Da 11.85 •
• database • 135 7 7 C3 JO 1 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct -
M ailing Address 4.75
Or 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 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator
Residential 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 /'
structural gas calcs. See footnote 1 3.75 �/
Type of fuel: oil 0 natural gas7C LPG 0 electric 0 22) More than 4 -per outlet (each) .75 •
Minimum Permit Fee $50.00 SUBTOTAL Atiati , , , ,m m.::: ; 56,° v
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE \ MIN Sl. O(�
given is correct, that I am the owner or authorized agent of • PLAN REVIEW 25% OF SUBTOTAL ' ._ *"`' ='� =;t
he ow that plans %V mitted are in compliance with Or gon tate laws. Required for ALL commercial permits only 4,-,-,,,,'g,, „ ". Other � r Or q � TOTAL � �(�
i gnature of •wner / t ent to
Other Inspections and Fees:
1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name Phone 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: 1 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 *State Contractor Boiler Certification required
units.
- **Residential NC requires site plan showing placement of unit
I:\mechperrn.doc rev 7/19/99
Case Activity Listing 1/7/2005
1:59:56PM
TIDEMARK Case #: MEC2000 -00005
COMPUTER SYSTEMS, INC
. ems„
a� „c :;:r149;' mss'' , /.
\�..i ;9 ..: :'A ned - onVAR "il ,. d ated :
!
.... , : - -Date ll s o B •'.Notes
o '"
p. Y < ,
MECA007 Application received 1/5/2000 None DONE DEB 1/5/2000
DST
MECA008 Create Permit 1/5/2000 None DONE DEB 1/5/2000
DST
MECA705 G Line Insp 1/5/2000 1/5/2000 1/6/2000 None PASS TLP 1/6/2000
AKJ
MECA799 Final Inspection 1/5/2000 1/5/2000 3/7/2000 None PASS TLP 3/7/2000
AKJ
MECA060 (F) Issue permit 1/5/2000 None DONE DEB 1/5/2000
DST
MECA800 Case Finaled 3/7/2000 None DONE AKJ 3/7/2000
AKJ
MECA075 (F) Reprint Permit 3/9/2000 None DONE BON 3/9/2000
BON
Page 1 of 1 CaseActivity..rpt
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CITY OF TIGARD BUILDING INSPECTION DIVISION jr -On y 63
24 -Hour Inspection Line: 639-4175 Business Line: 639 -4171
BUP
Date Requested 3 AM PM _ BL
66 O
Location 165M ( 14kU J Suite ME 2(ov - 0W0 S
Contact Person (ri I'V1 Ph %, — Y 5, PLM
Contractor Ph SWR
ILDI x Tenant/Owner ELC
l ELR
Footing Access: �
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: J // f SGN
Slab / P�(.�� �L� SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
•
Fire Alarm
Susp'd Ceiling
Roof
Misc:
_'_ PART FAIL
°' BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final j ))
PASS PART FAIL
CH i�
Pos m 06„ Q,�` ugh In
Gas Line,"
Smoke Dampers
.,1140 PART FAIL
RICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
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 Q Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.