Permit CITY F TIGARD O
MECHAIV I CAL
�
DEVELOPMENT SERVICES PERMIT #PERMIT MEC99 -0040
'- -
DATE ISSUED: 01/26/99
PARCEL: 25111AD -15600
SITE ADDRESS...: 09020 SW REILING ST
SUBDIVISION • MALLARD LAKES ZONING: R -4.5
BL.00K........... L.OT....... •022 JURISDICTION: TIG
CLASS OF WORK..:OTR 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..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 1
FURN ( 100K BTU: 0 (= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Installation of a direct vent gas stove and gas piping.
. Owner: - FEES -- - - --
EDISON, DAVID & JONI type amount by date recpt
9020 SW REILING ST PRMT $ 25.00 DEB 01/26/99 99-- 312432
TIGARD OR 97223 5PCT $ 1.25 DEB 01/26/99 99- 31243:
Phone #: 620 -3555
Contractor: --
T & K MECHANICAL
TIMOTHY S WYNNE -. - -- --
11525 SW CANYON $ 26.25 TOTAL
BEAVERTON OR 97005
Phone #: 626 -4652
Reg #.. : 001211
REQUIRED INSPECTIONS -- - -- - --
This permit is issued subject to the regulations contained in the Gas Line Insp
— _-
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp _ -
applicable laws. All work will be done in accordance with Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection _
within 180 days of issuance, or if work is suspended for more _
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 -001 -0010 through OAR 952- 001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue : &_ Permittee Signature: .
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + ++ + + + + + + + ++ + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(5 03) 639 -4171, x304 . Date to DR
. Print or Type Permit# lk,� 0
• Incomplete or illegible applications will not be accepted Called
Name of Development/Pro)eet Description
Table 1A Mechanical Code Pri0e Amt
Job Street Address f Sure# A) Permit Fee 10.00
Address Qkda Scci 4i ( 1 nci S4 1) Furnace to 100,000 BTU •
including ducts & vents 6.00
Bbd CRy/Sta zip 2) Furnace 100,000 BTU+
including ducts & vents 7.50
Name (pr name of business) 3) Floor Furnace
Owner E ci i .s ,Thu I ci 4- jov I Including vent 6.00
Mailing Address 4) Suspended heater, wall heater
ClO aO f or floor mounted heater 6.00
SW Re i 1 (R c/ a' 5) Vent not included In appliance permit
City/State Zip I Phone 3.00
d CV oat/ ,,g - 3�
�� y CHECK ALL 'Boiler Heat Air
(or mane of business) THAT APPLY: or Pump Cond Qty Price Amt
c„ Comp
`lC c 6) <3HP;absorb unit to
Occupant Mailing Address 100K BTU 6.00
7) 3-15 HP;absorb unit
Cfty/State Zip Phone 100k to 500k BTU 11.00
8) 15-30 HP; absorb .
unit .5-1 mll BTU 15.00
Contractor Name �/ / // . 9) 30-50 HP; absorb
T c o - /'"t Q tit; CAF unit 1 -1.75 mil BTU 22.50
Prior to permit Mel Address /� 10) >50HP; absorb unit
issuance, a copy /5 a..4..) can y011 >1.75 mil BTU 37.50
of all licenses /State / pp Phone 11) Air handling unit to 10,000 CFM
are required if Q 1)-01',101 !"loos 'o7L-Y�c 4.50
expired In COT Oregon Coral. Cont. Board 1 -log Exp. Date 12) Air handling unit 10,000 CFM+
databas e �pC / / S 7.50
Architect N 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 CRY/State Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe walk to be done: 4.50
17) Domestic incinerators •
New 0 Re air 0 Replace with like kind: Yes 0 No 0 7.50
Residential Commercial 0 18) Commercial or industrial type Incinerator
30.00
Additional information or description of rk: J I 19) Repair units
DIY4Cr� \Q4- PUVrLr U � 59CX- 4.50
20) Wood stove /jt _ / k. eic 15 i vi 21 Clothes d tc. rod bel gas .ion 4
• 21) thy , etc.
4.50
Type of fuel: oil 0 natural gas \PG O electric tt, — 22) Other units •
�� 4.50
I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets //11
given is correct, that I am the owner or authorized agent of 2.00 4. co
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Signature of - Age Date
' Minimum Permit Fee $25.00 SUBTOTAL . ' 00
(.CX fil/ .) hiA'
/ �?� 5% SURCHARGE
j. 4
arson Name Phone PLAN REVIEW 25% OF SUBTOTAL
C.._
O fly, e (��� // / Required for ALL commercial permits only , A (, _ `1(U TOTAL
*State Contractor Boiler Certification required
"Residential NC requires site plan showing placement of unit • _
I:lrnechperm.doc rev 07/20/98
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ''f AM PM BLD
Location Suite MEC 9 DO yD
Contact Person Ph 6 q E/ PLM
ontra .r 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 _ —C-
Fire Sprinkler '— � J
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING 46/.16?
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
FAIL
P. Beam
417,q fe21
,-`e Dampers
(44-
) PART FAIL
TRICAL
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 1 ,
Other oach /Sidewalk Date � / I nspector `% P' Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.