Permit II UHHN 1 LHL V
PERMIT
CITY OF T DATE O6/28/966 -0 07
COMMUNITY DEVELOPMENT DEPARTMENT PARCEL: 1 S 136 DB- 00201
SITl�31rfUlJh(P , Blvd . Tiggrd.prjeso4`j7?823e8I-�H th5f f1.; -4Fiw
SUBDIVISION • W Op
Aq ZONING: C —G
BLOCK LOT
CLASS OF WORK..:REP FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:? VENTS W/0 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 REPIR 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.: 0
FURN < 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS. : 1
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks: Installing gas piping for gas water heater
Owner: FEES
ALPINE DRY CLEANERS type amount by date recpt
11569 SW PACIFIC HWY PRMT $ 25.00 B 06/28/96 96- 281169
SPCT $ 1.25 B 06/28/96 96- 281169
TIGARD OR 9723
Phone #:
Contract or:
GEORGE MORLAN PLUMBING
5529 SE FOSTER RD
PORTLAND OR 97206
Phone #: 771 -1145 $ 26.25 TOTAL
Reg #..: 02734
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 Final Inspection
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.
1
Perm Si nature: ,.. At ,
_
i
ffik Issued ed By: I
Call for inspection — 639 -4175 •
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit # lkt 6 07-01
Tigard, OR 97223
(503) 639 -4171
Name of Development Description
1 1 p Q� Q Table 3A Mechanical Code QTY PRICE AMT
e s.
Job ` 569 � u aC 1 L 1-14" 1) Permit Fee -0- -0- 10.00
Address �fstate l �1
TI(Q U Vr 9'/ 2.:V3 J
2) Supplemental Permit 3.00
Name me of busmen) Furnace to 100,000 BTU
1) incl. ducts & vents 6.00
M&Ear9 Address Phone Furnace 100,000 BTU +
Owner 2) incl. ducts & vents 7.50
C,ty /State vP Floor Furnance
3) incl. vent 6.00
Name (or name of twsmess) Suspended heater, wall heater
4) or floor mounted heater 6.00
Madmp Address Phone Vent not incl. in
Occupant 5) appliance permit 3.00
City /State Zip Repair of heating, refrig.
6) cooling, absorption unit 6.00
Name Boiler or comp, heat pump, air cond.
0 • ■ ■ I t 7) to 3 HP; absorp unit to 100K BTU 6.00
• 9 r • ■ ens t A Pact en Boiler or comp, heat pump, air cond.
1 - 5 V \1 K V v 8) 3-15 HP; absorp unit to 500K BTU 11.00
Contractor /State Boiler or comp, heat pump, air cond.
1.. d 0 e. a k %.-11 9) 15-30 HP; absorp unit .5-1 mil BTU 15.00
e - a-I a • °• •" ° °' '° Boiler or comp, heat pump, air cond.
02 96 4 222 10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that I have read this application, that the Boiler or comp, heat pump, air cond.
information given is correct, that I am the owner or authorized 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with Air handling unit to
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50
Board, that the number given is correct. (If exempt from State Air handling unit '
registration, please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected
g I 15) to a single duct 3.00
I Ventilation system not
i 4,1 ..1 A 6 2B _9 e 16 ) included in appliance permit 4.50
�:. • • a
er or agent Hood served by
17) mechanical exhaust 4.50
o ,e work new 0 addition 0 alteration 0 repair 0 iCommercial or industrial
to one residential 0 non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of 20) Gas piping one to four outlets V 2.00
building or property
21) More than 4 -per outlet (each) 2.00
Type of fuel - oil 0 natural gas D® LPG 0 electric 0
NOTICE
Minimum Fee $25.00 SUBTOTAL � v V
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE / 2-5
IF CONSTRUCTION OR WORK IS SUSPENDED OR '
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED. ' n ✓
TOTAL �j
Special Conditions
Date issued by
H:1LOGI MDSTSIMECHPMT
•
5/9/00 Activities for Case #: MEC96 -00207 EXPIRED
3:45:38 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 6/28/96 B RECD BON 6/28/96 •
. MECC008 Permit created 6/28/96 B PEND BON 6/28/96
MECC799 Final Inspection BON 6/28/96
MECC705 Gas Line Insp 6/28/96 BON 6/28/96
MECC090 (F) Issue permit 6/28/96 B PASS BON 6/28/96 •
MECA880 Expired by limitation 4/18/00 HAP DONE No Hold AKJ 4/18/00
Page 1 of 1
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested AM PM BLD
Location /15e2 L. 1i G t Suite MEC 9 6 - 6 6 2 € 3 . - 7
Contact Person Ph PLM
Contractor Ph SWR
. � �1
BUILDING Tenant/Own N' (2 ) ' 01. ELC
Retaining Wall ELR
Footing FPS
Foundation NOT REQUESTE
Ftg Drain FOUND DURING RESEARCH SGN
Crawl Drain S
NO INSPECTION(S) FOUND IN FILE
Slab SIT
Post & Beam .t401 5.03 p , ,00 1o✓ e,v 11
Ext Sheath /Shear �7
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab EXPI�
Top op Out E®
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
ECHANICAL
Post & Beam
Rough In
Gas Line
Sm • ke Dampers
PART FAIL
ELECTRICAL
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 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.