Permit CITY OFTIGARD
��,r i, 1, DEVELOPMENT SERVICES MEFERMITAL
°' 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # ' ° MEC98 -0578
DATE ISSUED: 12/31/98
PARCEL: 2S115BA -00600
SITE ADDRESS...: 16105 SW PACIFIC HWY
SUBDIVISION • ZONING: R -12
BLOCK • LOT • JURISDICTION: KIN
CLASS OF WORK ° °:OTR FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE °COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP. °:R1 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 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.: 2
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Installation of pool & spa heaters and associated gas piping.
Owner: FEES
KCM ASSOCIATES LLC type amount by date recpt
10895 SW FIFTH PRMT $ 25.00 DEB 12/31/98 KING CITY
BEAVERTON OR 97005 5PCT $ 1.25 DEB 12/31/98 KING CITY
Phone #:
Contract or:
LARRYS HEATING
LARRY E SOUTHARD
4925 NW FRUIT VALLEY RD $ 26.25 TOTAL
VANCOUVER OR 98685
Phone #: 360 - 574 -9334
Reg #. ° : 63575
REQUIRED INSPECTIONS
This pervit is issued subject to the regulations contained in the Mechanical 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 permit will expire if work is not started
within 180 days of issuance, or if work is suspended for lore
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 952-081-w through OAR 952 -001 -0080. You lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue Permittee Signature: y am/ a -,-
........_ _ r
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Application Plan Ct
CITY OF TIGARD Mechanical Permit A _
PP Recd By,. A - `_� .�1
- 13'1 SW HALL BLVD. Commercial and Residential .° Date Recd a o `'
TIGARD, OR 97223 D 'Q g Date to P.E.
(503) 639 -4171, x304 0 6 t9)1 Date to DST
Print or Type Perri** Mae /e -657e
Incomplete or illegible applications will not be accepted Called
Name of D rOnrnt/Projeyt Description
/�JJ (za 1 ° � `S E7-5" Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 10.00
Address 1) Furnace to 100,000 BTU
ddress
�fJ /D '- �c / //� 17( including ducts & vents 6.00
Btdg# City/State Zlp 2) Furnace 100,000 BTU+
f/n G � y including ducts & vents 7.50
Name (or name of business) / 3) Floor Furnace
Owner C /17 4 s.s /Jc /a/£ L I (i. including vent 6.00
Md ing Address f 4) Suspended heater, wall heater
or floor mounted heater 6.00
ib'S 9 5 ,S W d 57-
5) Vent not included in appliance permit
City/State -- Zip Phone 93 3.00
.7Yflf/B / 1 700s'" g 9 2 CHECK ALL Toiler Heat Air
e rne (or name of business) THAT APPLY: or Pump Cond Qty Price Amt
' Comp
Mailing Address 6) <3HP;absorb unit to
Occupant g 100K BTU 6.00
7) 3-15 HP;absorb unit
City /State Zip I Phone 100k to 500k BTU 11.00
l l 8) 15-30 HP; absorb
unit .5-1 mil BTU 15.00
Contractor N
L A / s � u) 30-50 HP; absorb
reds / / unit 1 -1.75 mil BTU 22.50
Prior to permit Mailing Add / 10) >50HP; absorb unit
issuance, a copy eig /2 /'v w J9 7 ' 3 Ldp/ >1.75 mil BTU 37.50
of all licenses City/State Zip Phone s-66 11) Air handling unit to 10,000 CFM
are required if 1/21 Cep v,E' ✓ fi,�fl4 SJ / 9�.3g� 4.50
expired in COT Oregon Const. Cont. Board Exp. Date 12) Air handling unit 10,000 CFM+
database G 3 7, 3 -- 7.50
Architect N8R1e 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 Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
Newt Repair 0 Replace with like kind: Yes 0 No 0 7.50
Residential 0 Commercial 0 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 O natural gas LPG O electric O 22) Other units y -
k :� - -," " 'G ii ; tc 7i 4.50 '
I hereby acknowledge that I have 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 1 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Signature of Owner /Agent Data r e = • '
60 ��� . 9 -5 / ,, Minimum Permit Fee $25.00 SUBTOTAL ) rr.-1
12 0
5% SURCHARGE
h son Name Phone PLAN REVIEW 25% OF SUBTOTAL
Required for ALL commercial permits only
TOTAL i 1
S tate Contractor Boiler Certification required
~Residential NC requires site plan showing placement of unit
I:\rmechperm.doc rev 07/20/98
•
Page No. 1 CASE HISTORY FOR CASE NO.: MEC98 -0578
KCM ASSOCIATES LLC
16105 SW PACIFIC HWY
01/08/99
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
- - -- - -- -- - --- -- - --
MECC007 Application received / / / / 12/31/98 RECD DEB 12/31/98 DRA
MECC008 Permit created / / / / 12/31/98 DONE DEB 12/31/98 DRA
MECC090 (F) Issue permit / / / / 12/31/98 Bob P reviewed and said to issue over DONE DEB 12/31/98 DRA
the counter.
MECC706 Mechanical Insp 12/31/98 / / 01/05/99 PASS GS 01/05/99 GES
MECC750 Misc. Inspection / / / / 12/31/98 Inspect venting 12/31/98 DRA
MECC799 Final Inspection / / / / 01/05/99 PASS GS 01/05/99 GES •
MECC800 Case Finaled / / / / 01/05/99 PASS GS 01/05/99 GES
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