Permit CITY OF TIGARD
MECHANICAL PERMIT
l� DEVELOPMENT SERVICES PERMIT #: MEC1999 -00381
- — 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 09/15/1999
SITE ADDRESS: 11990 SW LINCOLN AVE 0 R I GINAL PARCEL: 2S102AB -00901
SUBDIVISION: KIMBERLY ADDITION • ZONING: R -7
BLOCK: LOT: 001 . JURISDICTION: TIG
CLASS OF WORK: ALT 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:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: installation of new gas furnance and add gas line.
Owner: FEES
RICK RENNE Type By Date Amount Receipt
• 11990 SW LINCOLN PRMT GEO 09/15/19E $50.00 99- 318340
TIGARD, OR 97223 5PCT GEO 09/15/19E $3.50 99- 318340
• Total $53.50
Phone: 503 - 639 -9668
Contractor:
OWNER
REQUIRED INSPECTIONS
Gas Line Insp
Phone: Heating Unt Insp
Reg #: Final Inspection
This permit is issued subject to the.regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follo rules ado. -d in the Oregon
. Utility Notification Center. Those rules are set forth in OAR 952 1 I . -001 thro ! OA'' 952 - 001 -0080.
You may obtain c. •i:-.. e ►thes- ules or direct questions to OU b call 4 g (50 3 24. 9189.
Issue By: . , j , / •Permittee Signature: A •
Call (503) 639 -4175 by 7:00 P.M. for inspections eede. the next business day
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
T IGARD, OR 97223 Date to P.E. •
•
(503) 639 -4171, x304 Vr"j ` Date to DST
Print or Type Permit #' ? ' 9 p$ - 003 '/
Incomplete or illegible applications will not be accepted Called
Name of Dev ent/ ect Description
,�� Table 1A Mechanical Code Qty Price Amt
Job Street Address // Suite# A) Permit Fee 16.00
Address 1 1999 S(.,D `( ,^ CL7 L VL I 1) Furnace to 100,000 BTU It L g
including ducts & vents see footnote 1,2 8 9.65 9
e city /State D zl� 7j 2) Furnace 100,000 BTU+
d � S Vn ttnlw� 1 C/ 6,? including ducts & vents see footnote 1,2 12.00
Name (or nam of busin 3) Floor Furnace
Owner IL< c _- 'ems -, e including vent see footnote 1,2 9.65 •
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater see footnote 12 9.65
\ [ O AC-0 ,
` � �� 5) Vent not included in appliance permit 4.75
City /State Zip q Phone Check all that apply: *Boiler Heat Air
r A C / 7 Z.13 4 -9 `crra 2f For items 6 -10, see or Pump Cond Qty Price Amt
Na r name of busi ess) footnotes 1,2 Comp
^�_ 6) <3HP;absorb unit to • 100K BTU 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
104 to 500k BTU 17.65
City/State Zip Phone 8) 15 - HP; absorb
unit .5 -1 mil BTU 24.15
9) 30 -50 HP; absorb
Contractor ,, ( unit 1 -1.75 mil BTU 36.00
e ,mod
�, (�`� �M -� �/�f� 10) >50HP; absorb unit
Prior to permit Mailin Address >1.75 mil BTU 60.15
issuance, a copy , \ Q j C7 S ( _,DL-t ✓.. C-c.) LI.,..__- 11 Air handling unit to 10,000 CFM
of all licenses State Zip Phon ea ,,.,/ 7.00
are required if % tA� q 77 Z3 t"o 3 7 �! Ce (.. I4 12) Air handling unit 10,000 CFM+
expired in COT • Oregon onst. Cont. Board Lic.# Exp. Date 11.85
database 13) Non - portable evaporate cooler
Architect Name 7.00
5 , z 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 Repair 0 Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator
Residential K 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 calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 30 LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL - fLt -
reby acknowledg t I have read this application, that the information 7% SURCHARGE ,
iven • ict, th a the owner or authorized . of PLAN REVIEW 25% OF SUBTOTAL
the n t
kii
Ian s muted are in compl p5! - I /Grejorrlt, laws. Required for ALL commercial permits TOTAL
5
Signature of Owner /Agent Date
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
�t--&..v,--o-,' �� t�.�, � o� 69 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 _ _
Case Activity Listing 12/23/2004
1:36:01 PM
TIDEMARK Case #: MEC1999 -00381
COMPUTER SYSTEMS, INC.
Assigned Done Updated
Activity Description Date 1 Date 2 Date 3 Hold Disp To By By Notes
MECA007 Application received 9/15/1999 None RECD GEO 9/15/1999
GEO
MECA008 Create Permit 9/15/1999 None DONE GEO 9/15/1999
GEO
MECA705 Gas Line Insp 9/15/1999 9/15/1999 9/30/1999 None PASS MS 9/30/1999
AKJ
MECA725 Heating Unt Insp 9/15/1999 9/15/1999 10/14/1999 None FAIL MS 10/14/1999 Dirt wall need to be lined with
DGW concrete or masonry 4" above the
adjoining ground level. (adjoining
wall).
MECA799 Final Inspection 9/15/1999 9/15/1999 10/15/1999 None PASS MS 10/15/1999 after furthur review with building
MRS official we decided that installation
was ok
MECA060 (F) Issue permit 9/15/1999 None DONE GEO 9/15/1999
GEO
MECA800 Case Finaled 10/15/1999 None DONE MS 1/4/2001
AMS
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