Permit CITY OF TIGARD MECHANICAL
PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT # • MEC96 - -0031
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
EXPIRED DATE ISSUED: 02 / 06 / 9 6
PARCEL: 2S111BD -03100
SITE ADDRESS...: 09770 SW PEMBROOK ST
SUBDIVISION • CLOUD CAP ZONING: R -3.5
BLOCK; . LOT •13
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 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.. : l�
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS. : 1
FURN C 100K BTU: 1 (= 10000 cfm: 0 GAS OUTLETS.: 1
FURN ) =100K BTU: 0 > 10000 cfm: 0
Remarks: Install furnace, water heater, and as piping.
Owner : -• FEES --
SUE HOPE type amount by date recpt
9770 SW PEMBROOK PRMT $ 25.00 JSD 02/06/96 96- 275680
SPCT $ 1.25 JSD 02/06/96 96•- 275680
TIGARD OR 97223
Phone #:
Contractor:
COLUMBIA HEATING
PO BOX 230397
TIGARD OR 97281
Phone #: 624 -2704 $ 26.25 TOTAL
Reg #..: 76359
REQUIRED INSPECTIONS
This permit 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 sore -
than 180 days.
Permittee cs; - re: ', ,� L,.. _ • .
Issued
Call for inspection - 639 -4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit #,416
Tigard, OR 97223
(503) 639 -4171
Nam, °f^w Description
I1 Q H pt. Table 3A Mechanical Code QTY PRICE AMT
Address .w �/ J 60 ',L" . TA br 1) Permit Fee -0- -0- 10.00
.4 a' "G >' "� q 7223 2) Supplemental Permit 3.00
^•^� Q Furnace to 100,000 Ell U
� l Q o Q�I x�.r e _ 1) incl. ducts vents / 6.00 6.00
Phone Furnace 100,000 131 U +
Owner 6W3 / 61 2) incl. ducts & vents 7.50
urifbm• Floor Fumance
3) inc.!. vent 6.00
N'"" ^■^& of^oss) Suspended heater, wall heater
' JM'ii2 Q6 ah(k.V.,Q_ 4) or floor mounted heater 6.00
MOM Occupant Vent not Incl. in
5) appliance permit 3.00
sisis • Lip Repair of heating, retng.
6) cooling, absorption unit 6.00
alidir Boiler or comp, heat pump, air cond.
J y!4 NiAil 7) to 3 HP; absorp unit to 100K BTU 6.00
P I Boiler or comp, heat pump, air cond.
Contractor Y ,q- 313397 (0� � 7 0 4 / '
(�y 8) 3 15 HP; absorp unit to 500K BTU 11.00
n � Boiler or comp, heat pump, air cond.
O1'_6 -7�Be� 9) 15 -30 HP; absorp unit .5 1 mil BTU 15.00
i LSO
430,r, anal Loy Too N Boiler or comp, heat pump, air cond.
_59,5-3/V / 10) 30 -50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that have rea i application, that Boiler or comp, heat pump, air cond.
information given is correct, that I am the owner or authorized agent 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
of the owner, that plans submitted are in compliance with State Air handling unit to
laws, that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air handling unit
please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected
15) to a single duct 3.00
{i imuZ� 2 _6 - 16) 16 Ventilation system nop
(` included in appliance ermit 4.50
ey�,m.. ow Hood served by
17) mechanical exhaust 4.50
Descnbe work new 0 addition U alteration Q repair U Commercial or industnal
to be done 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 /_ / J
Proposed use of 20) Gas piping one to four outlets / 2.00 02 ,0O
building or property
Type of fuel -oil gas O 21) More than 4 -per outlet
T
yp 0 natural as PG 0 electric
NOTICE C/ ��
Minimum Fee $25.00 SUBTOTAL , -U
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE
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.
TOTAL v2e19 Z
Special Conditions
Date issued by
krMECHPMT
woad,coiM.v
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone:_639 -4171
Inspection: %J J ( . " _ .4 _ /
I
Footing / Susp. Ceiling Sprink. :ou•h-in / Appr / dwlk
Foundation Plbg. Underslab ech. Rough -in Fireplace
Post/Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post /Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: c- / Time:_ AM PM
Address: 9 7 70 3
c �
Builder: (bt ., n- / mss l3 Co - V z70 7 Permit #, r-tZ. 6- CO 3
THE FOLLOWING CORRECTIONS ARE REQUIRED: 714- `')'' .
�-� -01 GEyT9�...ec
W /743aS A ../..<0 4.) MS: ? /9 �, L
41i -uv7�
-/- h —o e-
tQi 7 r 2 C�IA.c�i/r4 L j,k./ 77i -LI. A.r7 tyv
Inspector: r Date: - 2.../7/:96 : ,
APPROVED DISAPPROVED AWED SUBJECT TO ABOVE
Call For Reinsp.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested AM PM BLD
Location 4-71 0 P i b Sf Suite MEC `1 t ��,,vv
0 -COO 3 I
Contact Person - Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing
Foundation NOT REQUESTED FPS
Ftg Drain
Crawl Drain Ir
FOUND DURING RESEARCH SGN
Cr
Slab NO INSPECTION(S) FOUND IN FILE SIT
Post & Beam C,
Ext Sheath /Shear vASAu�.P , uYl4C2) W l+ 9 &S P'"
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm ` r
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab P
Top Out Pp'�
Water Service ��
Sanitary Sewer
Rain Drains 41-It O C)
Final
PASS PART FAIL
HANK
Post & Beam
Rough In
Gas Line
Score Dampers
in
PASS 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 p
Other D Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.