Permit CITY OF T I G A R D MECHANICAL PERMIT
i,� r DEVELOPMENT SERVICES PERMIT #: MEC1999 -00223
., � II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171. DATE ISSUED: 5/24/99
PARCEL: 2S115BC-08100
SITE ADDRESS: 16725 SW QUEEN ANNE AVE
SUBDIVISION: ZONING:
BLOCK: • LOT: JURISDICTION: KIN
CLASS OF WORK: OTR 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: 1 DOMES. INCIN:
LPG 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of furnace, a/c unit and associated gas piping. •
Owner: FEES
DOROTHY CASTON Type By Date Amount Receipt
16725 SW QUEEN ANNE AVE PRMT DRA 5/24/99 $25.00 KING CITY
KING CITY, OR 97224 5PCT DRA 5/24/99 $1.25 KING CITY
Total $26.25
Phone: 598 -3947
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE
PORTLAND, OR 97217 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 -281 -0752 Heating Unt Insp
Reg #: LIC 008897 Cooling Unt Insp
Final Inspection
•
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 y obta' copies of these rules or direct questions to OUNC by cal ing (503)246 -91 9.
Issu By P ermittee Signature: , 411 p 1� ∎ t,�1-v•---J
Call (503) 639 -4175 by 7:00 P.M. for inspections nee the ext business day
CITY OF TIGARD RECEIVIllitechanical Permit Application RecdByyck*R
13125 SW HALL BLVD. Commercial and Residential Date Reed s'- q'
TIGARD,' OR 97223 MAY 2 4 Date to P.E
(503) 639 -4171, x304 Date to DST S -7-di .4/.1
DEVELOPMENT Print or T -e t1 . -° Permit# H€ l 9 00223
Incomplete or Illegible applicati • - , •' not be accepted Called
Name
o r Dove Table ption • . •
de._ Table 1A mechanical Code Price Amt
Job Street gees S A) Permit Fee 1 p.p ��
//���� 1) Furnace to 100,000 BTU
Address . /o . /o �f07s.�ll,��,ew Including ducts a vents s.00 . / f
SIcipS 0° ap 2) Furnace 100,000 BTU*
` / i(,(� f fa including duets 8 vents 7.50
Name (or name of eustnm�b' 3) Pinar Furnace •
Owner -0 . /, i�� Including vent 6.00
A 4) Suspended heater, wall heater
Malting or floor mounted heater 5.00
• • 5) Vent not Included In appliance permit
CayiState Lp 1 Phone _ 3,00
CHECK ALL *Boiler Heat Air
N or ram business) THAT APPLY: or Pump Conti Qty Price Amt
Comp ` ..
6) <3HP;ebsorb unit to / /
to
Occupant Maumee A dm" 100K BTU ' / s.00
1, , 7) 3-15 HP;absorb unit
CM lase Zip 100k to 600k BTU • 11.00
� / 6 9 f og _dovy 8) ) unit 15-30 .5.1 m HP il ; B TU absorb
Contractor
9) 30-50 HP; absorb 15.00
,��/� !,, ��
er�i�� ... /� � 10) >50HP albsoib.unit 22,50
Prior to permit //� •
issuance, a copy 1�3ZD ) - '1�,1l >1,75 mil BTU 37.50
of all licenses tYlst�te Zip Pa. 11) Air handling unit to 10,000 CFM • '
are required if ,��.,i�(i ( �¢ 1 ha / 7 _ �f D'/5 4.50
expired in COT • Oregon Cong.. . boas two bate • 12) Air handling unit 10,000 CFM}
database • 0.1", 7 Q / 41.0 7.50 •
Architect Nafe - 13) Non - portable evaporate cooler '
4.50
M ailing Address 1 d) Vent fan connected to a single dud
Or 3.00 •
15) Ventilation system not Included in
Engineer afly /wale Zip 1 P appliance permit ' 4.50 •
16) Hood served by mechanical exhaust •
Describe wort to be done: 4.50
17) Domestic indnerators •
New 0 Repair 0 Replace with like kind: Yes No O 7,50
Residential 0 Commerdal 0 • 18) Commercial or industrial type Indnerator
• 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 0 electric O 22) Other units .
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 2.00
the .., ; that plans su • In compliance with Oregon State laws ' 24) More than 4 -per outlet (each) '
, .
-./i.i; - .. — ` IV ...„ r. .. ./ _ ':?/ -0 .50 /
, re of • dAgent • Date •
Minimum Permit Fee $25.00 SUBTOTAL p?O
' bids/!!/ Pole— (d49PPKV //e. /.- /plA) _ 5% SURCHARGE' ., . •
Contact Person Nam, ' Phone, 7 / O 76,A— PLAN REVIEW 25% OF SUBTOTAL
Required for ALL commercial permits only , ,
TOTAL / 0...1: •State Contractor B oiler Certification required / �
— Residential NC requires site plan showing placement of unit .
IAmechperm.doc rev 0720198 . ,
•
6/30/99 Activities for Case #: MEC1999 -00223
1:25:46 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA060 (F) Issue permit 5/24/99 DRA DONE No Hold DRA 5/24/99
MECA007 Application received 5/24/99 DEB FAX No Hold DRA 5/24/99
MECA008 Create Permit 5/24/99 -DRA DONE No Hold DRA 5/24/99
MECA705 Gas Line lnsp 5/24/99 5/24/99 No Hold DRA 5/24/99
MECA725 Heating Unt lnsp 5/24/99 5/24/99 • No Hold DRA 5/24/99
MECA730 Cooling Unt lnsp 5/24/99 5/24/99 No Hold DRA 5/24/99
MECA799 Final Inspection 5/24/99 5/24/99 6/9/99 TLP PASS No Hold AKJ 6/9/99
MECA800 Case Finaled 6/9/99 AKJ DONE No Hold AKJ 6/9/99
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Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
� ] �j BUP
Date Requested LO I 6 I AM PM er BLD
Location / (172S ( l/tee)fIQ, 1114,te Suite MEC c
Contact Person T91( AA) Ph Z) 67SZ PLM
Contractor Ph SWR
BUILDING Tenant/Owner 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 /�
Fire wall /9 hit 00/Lip /PeMi �U t U� /v �
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
r Undt er Sl Un ab S i /9
dr l
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final -
PASS PART FAIL
( ion
Post & Beam
Rough In
Gas Line
Smoke Dampers
in
A PART FAIL
CTRICAL
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. at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: � ] Unable to inspect - no access
ADA ,-%/1/11W Approach /Sidewalk C � � �,��
Other Date > (?, Inspector • Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.