Permit CITY TIGARD MECHANICAL PERMIT
v DEVELOPMENT SERVICES PERMIT #: MEC1999 -00199
All' e
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/10/99 PARCEL: 2S114BC -01200
SITE ADDRESS: 10050 SW RIVERWOOD LN
SUBDIVISION: PICKS LANDING NO.1 ZONING: R -4.5
BLOCK: LOT: 067 JURISDICTION: TIG
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: DOMES. INCIN:
GAS 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of gas cooktop /down draft vent w /remote blower & gas logs in existing fireplace.
Owner: FEES
KENFORD HOWELL Type By Date Amount Receipt
10050 SW RIVERWOOD LN PRMT DST 5/10/99 $25.00 99- 315216
TIGARD, OR 97224 5PCT DST 5/10/99 $1.25 99- 315216
Total $26.25
Phone: .
Contractor:
OWNER
REQUIRED INSPECTIONS
Gas Line Insp
Phone: Mechanical lnsp
Reg #: Misc. Inspection
/iN *[ / N5P.
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
Util , 'oti ic...n Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
YO u may obtain ..pies of essee r les or direct questions to OUNC by calling (503)246 -9189.
Is ue By: ( . , /:I l / Permittee Signature: / .. . ./.:(
r
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan C eck #
C IT Y ' OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec - /C -p is
TIGARD, OR 97223 Date to P.E. ---
(503) 639 -4171, x304 - Date to DST
Print or Type ►MS 9 -co - Permit# H 999-05
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Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee - 4 \ ''' 10.00
Address V:050 30 Q11uer L - 1) Furnace to 100,000 BTU
Bldg# City /State Z; including ducts & vents see footnote 1,2 6.00
2) Furnace 100,000 BTU+
1 7p ird, OR cn22.4 including ducts & vents see footnote 1,2 7.50
Name (or name of business) 3) Floor Furnace
Owner �nLr including vent see footnote 1,2 6.00
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 6.00
' CX,I yv, CRS O C3✓e. 5) Vent not included in appliance permit
City /State Zip Phone 3.00
Check all that apply: *Boiler Heat Air
Name (or name of business) For items 6 -10, see or Pump Cond Qty Price Amt
footnotes 1,2 Comp
Same- OS e_r 6) <3HP;absorb unit to
Occupant Mailing Address 100K BTU 6.00
7) 3 -15 HP;absorb unit
City /State Zip Phone 100k to 500k BTU 11.00 _
• 8) 15 -30 HP; absorb
Contractor Name unit .5 -1 mil BTU 15.00
9) 30 -50 HP; absorb
t uvtl2X unit'1 -1.75 mil BTU 22.50
Prior to permit Mailing Address 10) >50HP; absorb unit
issuance, a copy >1.75 mil BTU 37.50
of all licenses city /state Zip Phone 11) Air handling unit to 10,000 CFM
are required if ,1. 4.50 ,/ t) S
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 12) Air handling unit 10,000 CFM+
database - 7.50
Architect Name p 13) Non - portable eva cooler
GAsy
4- y 4.50
Or Mailing Address 14) Vent fan connected to a single duct
3.00
60 771 ". .vx. 5V 15) Ventilation system not included in
Engineer City /State Zip Phone appliance permit • 4.50
C.)C ea.-. C t Y. -A vats 6$5 13 16) Hood served by mechanical exhaust
Describe work to be done: �� S p _ 4.50
CjlftA ven w /ypmflg 5 t,T 1 t 17) Domestic incinerators
New 0 Repair 0 Replace with I le kind: Ye o O C'.>rt5 7.50
Residential Commercial 0 .41j a 18) Commercial or industrial type incinerator
`� 30.00
Additional information or description of work: 19) Repair units
4.50
20) Wood stove
NOTE: For Commercial projects only; Units over 400 lbs. require 4.50
structural gas calcs. 21) Clothes dryer, etc.
Type of fuel: oil 0 natural gasX LPG 0 electric 0 4.50
22) Other units J ' 4.50 g 6 76
I hereby acknowledge that I have read this application, that the information JO
given is correct, that I am the owner or authorized agent of 23) Gas piping one to four outlets .
the owner, that plans submitted are in compliance with Oregon State laws. See footnote 1 2.00
24) More than 4 -per outlet (each)
Sign ture of ner /Agent Date .50
ho ( U Minimum Permit Fee 25.00 SUBTOTAL • 4,:
Contac Person ame Phone z ° "',' '' ',....,,s-- ' 5
,,r
(020 -- Li4lQ2 5% SURCHARGE
Ken kcat).JP.AV PLAN REVIEW 25% OF SUBTOTAL
Foonotes for commercial projects only: Required for ALL commercial permits only ,
1. Provide full schematic of existing and proposed gas line and pressure. TOTAL i `.. 9, --
2. Provide drawings to scale showing existing and proposed mechanical ,,,.
units. *State Contractor Boiler Certification required
**Residential A/C requires site plan showing placement of unit
I:\rnechperm.doc rev 02/4/99
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6/9/00 Activities for Case #: MEC1999 -00199
3:58:48 PM
Assigned Hold Updated
Activity Description Date 1 Date 2` Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 5/10/99 DEB DONE No Hold DST 5/10/99
MECA008 Create Permit 5/10/99 DEB DONE No Hold DST 5/10/99
MECA715 Mechanical Insp 5/10/99 5/10/99 No Hold DST 5/10/99
MECA705 Gas Line Insp 5/10/99 5/10/99 No Hold DST 5/10/99
MECA750 Misc. Inspection No Hold DST 5/10/99 Gas logs
MECA060 (F) Issue permit 5/10/99 DEB DONE No Hold DST 5/10/99
MECA075 (F) Reprint Permit 5/10/99 DST DONE No Hold DST 5/10/99
MECA799 Final Inspection 11/15/99 11/15/99 11/15/99 TLP PASS No Hold VT 11/15/99
MECA800 Case Finaled 11/15/99 TLP PASS No Hold VT 11/15/99
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 9'? 0 )-673 ----
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Il(1 BUP
Date Requested 1 Li AM 9C BLD
Location / 6S b L-t Suite MEC 15q/00 q7
Contact Contact Person�Q Ph( (4-� -_.. PLM /
Contractor Ph SWR
BUILDING'- , ,.pit 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
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam \ f
Under Slab /
Top Out (((
Water Service
Sanitary Sewer
Rain Drains
Final
• :T FAIL
Post & Beam
Rough In
Gas Line
S Dampers
Cps PART FAIL V
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 — ` —' /�
Approach /Sidewalk D ate ////<I 1 Ci ( EXt
Other (7 7 Inspector
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
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