Permit T• 1
CITY OF TIGARD MECHANICAL PERMIT
��;* DEVELOPMENT SERVICES PERMIT #: MEC2000 -00002
,� I- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 01/05/2000
PARCEL: 2S101 BB -00400
SITE ADDRESS: 11844 SW PACIFIC HWY
SUBDIVISION: ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: 1 VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERSICOMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Install new gas heater and gas piping.
Owner: FEES
ENTERPRISE RENT A CAR Type By Date Amount Receipt
20400 SW TETON PRMT KJP 01/05/200 $50.00 00- 320906
TUALATIN, OR 97062 5PCT KJP 01/05/20C $4.00 00- 320906
Total $54.00
• Phone: 503 - 612 -8111
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 281 -0752 Mechanical lnsp
Reg #: LIC 008897 Final Inspection
ORIGINAL
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 Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246-9189. I
Issue By: Permittee Signature: x
l
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By
'0125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 1 1 y Date to DST
Print Print or Type / Permit# rrl G 2°do °coon.,
. ,q319,,,2 Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
,27` 4 i ( Table 1A Mechanical Code Qty Price Amt
Job A Permit Fee ,
Street Address Suite# A) 10.00
Address p ,�I 1) Furnace to 100,000 BTU
r‘Idgir.-466) Cittelte "' including ducts & vents 6.00
City rate zip 2) Furnace 100,000 BTU+
97 including ducts & vents 7.50
Name (or name of business 3) Floor Furnace
Owner ��2 7›,s �� ,e�l "6..,,c- including vent 6.00
Mailing Addre °` �� 4) Suspended heater, wall heater i
WD lee - 4 . 'v / _ Vent floor mounted heater 6.00 to
7 f� p��� 5) Vent not included in appliance permit
City/State Zip Phone 3.00
a e__ & 44 970 6�� /N CHECK ALL *Boiler Heat Air
Name (or name of busines THAT APPLY: or Pump Cond Qty Price Amt
Comp
47��.(/�f,/ - ���- 6) <3HP;absorb unit to f
Occupant Mailing Addres4 100K BTU 6.00
//09.C..) A/r C� P �yf J 7) 3 -15 HP;absorb unit
6. ty/State • P ,fie 100k to 500k BTU 11.00
izza �/� 8i / � 8) 15 -30 HP; absorb
C ontractor 7 _4 4 4 / unit .5 -1 mil BTU 15.00
9) 30-50 HP; absorb
eh i, 44 0 , p - t 22 unit 1 -1.75 mil BTU 22.50
Prior to permit Mailing Address 10) >50HP; absorb unit
issuance, a copy -9 o?Zd - Ze2e.,®,l4� >1.75 mil BTU 37.50
of all licenses /State Zip Phone 11) Air handling unit to 10,000 CFM •
are required if goj 4 77gz / -.$7ae 4.50
expired in COT Oregon Const. Cont. Board Lic.# exp. gate 12) Air handling unit 10 CFM+
database nA 7 97 / /� / Q a 7.50
Architect Name / 13) Non - portable evaporate cooler
4.50
or Mailing Address 14) Vent fan connected to a single duct
3.00
15) Ventilation system not included in
Engineer City /State Zip I Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New-O
ew- Repair 0 Replace with like kind: Yes 0 No 0 7.50
Residential 0 Commerciaj� 18) Commercial or industrial type incinerator
�� 30.00
Additional information or description of work: 19) Repair units
4.50
20) Wood stove
4.50
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gas LPG 0 electric 0 22) Other units
4.50
I hereby acknowledge that I ve 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 -
t • ner, that plans submittehare in compplia�nce eith Oregon Stat laws. 24) More than 4 -per outlet (each)
2 L`c G= � � ��9�E C� a'.L�c - /e 0,D .50
4(1 u e er /Agent Date
Minimum Permit Fee $25.00 SUBTOTAL - 9
�� �. 4 -. ' _ .. 4 , 4 / i : ' D7 SURCHARGE '-
K
on tact Pe " n Name Phone PLAN REVIEW 25% OF SUBTOTAL ;..
Required for ALL commercial ``
q permits only ^.' .
• TOTAL }q}.1„�,
'.
*State Contractor Boiler Certification required
l "Residential NC requires site plan showing placement of unit
I:\mechperm.doc rev 07/20/9 Pi
1/20/00 Activities for Case #: MEC2000 -00002
1:32:00 PM _
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 APPlication received 1/5/00 KJP RECD No Hold KJP 1/5/00
MECC008 Permit created _ 1/5/00 - KJP DONE No Hold KJP 1/5/00 Per Bob P. no plan check
needed.
MECC706 Mechanical Insp 1/5/00 1/5/00 No Hold KJP 1/5/00
MECC705 Gas Line Insp 1/5/00 1/5/00 No Hold KJP 1/5/00 -
MECC799 Final Inspection 1/5/00 1/5/00 1/14/00 TLP PASS No Hold AKJ 1/18/00
MECC090 (F) Issue permit 1/5/00 KJP DONE No Hold KJP 1/5/00
MECC800 Case Finaled • 1/18/00 AKJ DONE No Hold AKJ 1/18/00
•
Page 1 of 1 •
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 G - 2 g7
Date Requested � n ,/ I (� ) AM PM BLD
Location — ! vl 1 0' 4_ C, Suite ME 2O -6Y
Contact Person - E 4" YM Ph gig I 0 Z PLM
Contractor Ph SWR
DIN 4 - 4gg Owner 'IJ i V / 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 fl-A • ,p O °Z-r Di f4/1 TWA- 4- Hy
0
C.� it -=
S S PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
I ECHANIGE
Post & Beam a )
Rough In a
Gas Line
Smoke Dampers , no.)
ZED'
PART FAIL
1s 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 Date . Inspector Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.