Permit r
CITY OF T MECHANICAL
i , ,, DE VELOPMENT SERVICES PERMIT
- �� 13125SWHalI Blvd., Tigard, OR 97223 (503) 639.4171 DARE I T S • MEC97 -0389
DATE ISSUED: 10/13/97
PARCEL: 2S110DC -02200
SITE ADDRESS...: 15532 SW PACIFIC HWY
SUBDIVISION • WILLOW BROOK FARM ZONING: C —G
BLOCK • LOT •011 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
. 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 UNITS AIR HANDLING UNITS OTHER UNITS.:11
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Retrofit MAC ductwork for new space.
Owner: FEES
POSTAL ANNEX type amount by date recpt
15532 SW PACIFIC HWY PRMT $ 59.50 GEO 10/13/97 97- 300009
STE 1 PLCK $ 14.88 GEO 10/13/97 97- 300009
TIGARD OR 97224 5PCT $ 2.98 GEO 10/13/97 97- 300009
Phone #:
Contract or:
SPARKS, ROBERT D
A CARPENTER'S SON
6765 SW 196TH $ 77.36 TOTAL
ALOHA OR 97006 -0000
Phone #: 649 -8850
Reg #..: 000864
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Fire Damper Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This per.it will expire if work is not started
within 180 days of issuance, or if work is suspended for wore
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 952-0014010 through OAR 952 -001 -0080. You lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
//
Issue By • • t.;-_,-,:v.. .ii -i Permittee Signature x
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + +++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
• Plan Check #'{l =f
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Comrrlercial bnd Residential Date Recd
TIGARD, OR 97223 a VL Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # g - 6-3`1
Called
Incomplete or illegible applications will not be accepted
Name of Development/Protect it I Description
Trt5 \... A n n py 5 - 94 fn Table 1A Mechanical Code CITY PRICE AMT
Job Street Address - Suited A) Permit Fee -0- -0- 10.00
Address 1 5532 S. W S.W. RC , no-- . (
Bld City /State Zp 1.) Furnace to 100,000 BTU 6.00
Y a.,4. ProcrY_n. """nO A. ' e t''1 224 including ducts & vents
NMne (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner 0A ■ s PatAk a- SA- 0,,dr1 ..A. including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
I `1 211 , 14 .'V(. Lake 5hocc, Coin including vent
City /State Zip Phone 4.) Suspended heater, wall heater - 6.00
'Po - - - ()R C+1229 • or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
PO 5 - Aunt yc
Occupant Mailing Address 6.) Boiler or comp, heat pump. air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City /State Zip I Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP: absorb unit to 500K BTU"
Contractor N8f1e 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to A (` a i t s -S Sparks / PCr, De,--� 15-30 HP; absorb unit.5 -1 mil BTU"'
issuance Mailing Add , 9.) Boiler or comp, heat pump, air cond. 22.50
applicant C5'1(05 S. W , ) bt („ 1 30-50 HP: absorb unit 1- 1.75mi1 BTU"
must provide all City/State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor I$.m},a Cot 4r)oo') to L}ct -8850 > 50 HP; absorb unit 1.75 mil BTU"
license Oregon Const. Cont. Board tic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50 •
information CiMo 4i Szt 10 -9PS
for COT COT Business Tax or Metro C Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database).
Architect N811e 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer city/state Zp - Phone 15.) Ventilation system not included in , ` 4.50
appliance permit Y
Describe work New 0 Addition 0 Alteration Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional Description of work r 17.) Domestic incinerators 7.50
TO tecro-fr,i t1VAG sr `FOr nevi S•aL'e
18.) Commercial or industrial type 30.00 _
Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove r 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Dud' vJ Qdreb -s.a' II frilvi
Type of fuel - oil 0 natural gas 0)' LPG 0 electric 0 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4-per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Signature of Owner/Agent Date 'SUBTOTAL M51)
,0 nn 5% SURCHARGE AO
- a"k 10- 7- 47 ,
Contact Person N e l Phone PLAN REVIEW 25% OF igi-gt*
TOTAL
• 7
if dst\mechpmtdoc (rev 9 'Minimum permit fee is S25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit.
OVER - THE - COUNTER (OTC) PERMIT
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Description of Project: ' — MDLII#J4 A 4Itra-5 4.7)11 4 Aa
' 1pll ,MlD A2ThlA ud...l Are-
Class of Work: At-1 Floor Furnace: Evap Coolers:
Type of Use: CO 4 1 Unit Heaters: Vent Fans:
Occupancy Grp: Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
/ / / / 3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: < = 10000 cfm: Oth Units: it
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn > =100k Btu: // /1
NOTES: T i` s 'DoIT Ap -h he 4 3tlP
,eFou4 Wait- — Do Ayr' 0,1 , _ - a., CJ1&t C �• s • 1!.1.446e- a_ ,� �- AN
•
MMIiAeRC.... 10N....K71pN.. t .:.;:;;.:. <'> ;:>:;:;>:n: M EIiE __ .................. .
$ .1 Permit Fee
Gas Line Inspection $ 1 4.44 Plan Review
Mechanical Inspection $ 70 5% State Surcharge
Cooling Unit Inspection $ Additional Permit Fee
Shaft Inspection $ Additional Plan Review Fee
Hood Inspection $ Inspection Fee
Fire Suppr Inspection $ Miscellaneous Fee
Duct Inspection
Fire Ala •• • _ ' • ,
• Fire 'am•er In . _,;,.n REMARKS:
• Miscellaneous In • - on
Fire Alarm In ection
in Inspectio
FFIGE.E�
> .::.:..:. ::.::::.........:..::..:PIE...: •.::::::::::::::::.:::::.: �:::.::::::::::.:::.:..:::::::.:::::.....:.................:.:::::::::..::.:.::.:::.......::::::.:::::..:: �::::::.:::::::::::::::.::::::::::: .:::::::::::::.::::::........:.
OF::USEs:OPTl.O. 'r CQM: -.:.
C ASS:: OF: ;WORK:.OPTIONS'FOR >ALL::PERMI'E — — ; —
S.
FND foundation; 0TH = att►er DEM : demolition . REP repair; FPS:: ltre.profecton,system. NOTE =USE 0TH: FOR: FENCES, :::::.:::::..;:.:;::;:;;
: RETAINING WALL DETACHED. DECKS, SIGt S, AWNINGS CANOPIES) ; < r ': `' :
is \ovrcntr.doc (dst) 8/97
1
Page No. 1 CASE HISTORY FOR CASE NO.: MEC97 -0389
POSTAL ANNEX
15532 SW PACIFIC HWY Unit: C -1
12/01/97
Action Description Reg/ Scbd/ End/ Action Notes Diep By Update Upd
Code Sent Done Done Date By
MECC007 Application received / / / / 10/13/97 RECD GEO 10/13/97 GEO
MECC008 Permit created / / / / 10/13/97 PASS GEO 10/13/97 GEO
MECC011 Routed to Plans Examiner / / / / 10/13/97 PASS RP 10/13/97 GEO
MECC014 Plan checked /Approved by P.E. / / / / 10/13/97 PASS RP 10/13/97 GEO
MECC016 DST Post- Review Completed / / / / 10/13/97 PASS GEO 10/13/97 GEO
MECC090 (F) issue permit / / / / 10/13/97 PASS GEO 10/13/97 BON
MECC750 Misc. Inspection 10/13/97 / / 10/29/97 Minor duct alternation approved. PASS TLP 10/29/97 J *H
MECC799 Final inspection 10/13/97 / / 11/07/97 PASS TLP 11/07/97 J *H
MECC800 Case Finaled / / / / 11/07/97 PASS TLP 11/07/97 J *H
•