Permit CITY TIGARD MECHANICAL PERMIT
PERMIT #: MEC1999 -00528
1i( DEVELOPMENT SERVICES DATE ISSUED: 12/01/1999
13125 S Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136AD -01700
SITE ADDRESS: 06875 SW PINE ST
SUBDIVISION: VILLA RIDGE ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES: 1
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: < =10000 cfm:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of a gas fireplace insert and gas line.
Owner: FEES
JULIE MACCANNELL Type By Date Amount Receipt
6875 SW PINE ST PRMT GEO 12/01/19E $50.00 99- 320113
TIGARD, OR 97223 5PCT GEO 12/01/19E $4.00 99- 320113
Total $54.00
Phone: 503 - 246 -6120
Contractor:
PIONEER FURNACE
3615 NE BROADWAY
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 249 -5000 Woodstove Insp •
Reg #: LIC 36102 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 the e rules or direct questions to OUNC by calling 503)246 -9189.
Issue By: ..4/ A O% - Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
11/18/99 THU 11:30 FAX 503 598 1960 CITY OF TIGARD lJ002
`r L Plan Check #
• CITY OF TIGARD Mechanical Permit Application Reed By
13125 SW HALL BLVD. Commercial and ResidentiBE Date Recd
TIGARD, OR 97223 Date to P.E. -. (503) 639 -4171, x304 NOV 191999 Date to DST
Print or Type . Permit itl /QQ9 i
• Incomplete or illegible applications w th acc Called
Name of Development/Project Description •
Table 1A Mechanical Code Qty Price Amt
Job Street Address C Sum{ A) Permit Fee , ... 16.00
Address fa e- 7.5'S'IAJ ei S-1-. 1) Furnace to 100,000 BTU _
Bldg# Clry/State Zip
including ducts 8 vents 9.65
2) Furnace 100,000 BTU+
7?q Q� dJ 72 Including ducts & vents 12.00
Time ame (or me of business) Li A l �y�i 3) Floor Furnace
Owner (,��/i Including vent 9.65 -
ailing Address • 4) Suspended heater, wall heater
4 ? 1 c w PIALs.4 or floor mounted heater 9.65
5) Vent not Included in appliance ermit 4.75
City /state zip Phone k that a ' Air
p� � 1 -yam PPly
i. Qew d `7 / p p�.'Lp 4 I . For Chec items all 6 -10, see . or Boiler Pump Heat Cond Qty Price Amt
or name of business) footnotes 1,2 Comp '"
6) Repair units
8.40
Occupant Mailing Address 7) <3HP;absorb unit to
100K BTU 9.65
City/State Zip Phone 8) 3-15 HP;absorb unit •
100k to 500k BTU 17.65
Contractor 9) 15-30 HP; absorb
/� as � unit .5-1 mil BTU
10) 30 -50 HP; absorb 24.15
re 611 Prior to permit ng Address. , • unit 1 -1.75 mil BTU 36.00
Issuance, a copy 36 ) , /V a) 11) >50HP; absorb unit >1.75 mil BTU
of all licenses city /state ���p Zia I P 60.15
are required if Vol ./ lJ(I� q71. ? to - S - bi'M 12) Air handling unit to 10,000 CFM
expired In COT oregpfi Const Cont. Board Lb.S �FFF��a Date D 7.00
database 3 C l D a (r a - 0 . 1 13) Alr handling unit 10,000 CFM+
Architect Name . 11.85
14) Non - portable evaporate cooler
Or Mailing Address - 7.00
15) Vent fan connected to a single duct •
. • 4.75
Engineer City /State Zip . Phone 16) Ventilation system not Included in
. appliance permit . 7 .00 .
Describe work to be done: 17) Hood served by mechanical exhaust
7.00
•
New 0 Repair Replace with like kind: Yes O. No 0 18) Domestic incinerators
Residential 0 Com mercial 0 Modification 0 12.00 .
19) Commercial or industrial type incinerator
Additional information or • tion of work: ' 48.25
71€491-44( 20) Other units, including wood stoves ( 700 9;7.1
NOTE: For Commercial projects only U over 400 lbs., located on the 21) Gas piping one to four outlets
roof, require structural talcs. prepared by licensed engineer. , 3.75 3).
Type of fuel: oil 0 natural gas %. LPG 0 electric 0 22) More than 4 -per outlet (each) .75
I hereby acknowledge that I have read this application, that the information Minimum Permit Fee $50.00 SUBTOTAL 2 " ^Ei �o 6 7
[+2.
•
8% SURCHARGE r [t -7,/
given Is correct, that am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL
the owner, that plans submitted are in compliance with Oregon State laws. Required•for ALL commercial permits only , _ _-
Signature of Owner/A Date dtilA
Mg r � TOTAL .- , __ ,. 3 ag.-ry
O - Other Inspections and Fees:
a e on Name Phone
y 1. Inspections outside of normal business hours (minimum charge two hours) $50.00 per hour
1 e / l ` •� y� 2. Inspections for which no fee Is specifically Indicated (minimum charge -half hour)
• Foonotes for commercial projects - o G1 3. Additiona l review required by changes, additions or revisions to plans (minimum
1. Provide full schematic of existing and proposed gas line and pressure. charge - one-half hour) 350.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
• units. "Residential NC requires site plan showing placement of unit
I:lmechperm.doc rev 11/1199
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 �h• -B � usiness Lin - • - 1
Date Requested S / r' Jb AM 9 1 / , �� BUP
^� n BLD
Location (0 ! C J r �✓� s � Suite MEC I q t9 57i�
Contact Person INIk { L4 � Ph 9-sono PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall V ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation C ✓J �
Drywall Nailing •
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
1141 1AV
b r k aiii
Pos • Beam
Roug
Li I
Gas Line
\ kerY
S i •ke Dampers
\If
...
•%! � �=� PART FAIL
ELECTRICAL
Service
Rough In
Low Vol
Low Voltage
Fire Alarm
1/411
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 10 Inspector / 6//i Ext
Final
PASS PART FAIL DO OT REMOVE this inspection record from the job site.