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Permit CITY OF TIGARD MECHAN I CAL DEVELOPMENT SERVICES PERMIT !J. J 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PERMIT # 2 / 9 8 —0222 DATE ISSUED: 06/12/98 PARCEL: 2S103CC -02000 SITE ADDRESS...: 12040 SW ROSE VISTA DR SUBDIVISION • COLONIAL VIEW ZONING: R -4.5 BLOCK • LOT -015 JURISDICTION: URB 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 gas fire log in fireplace of residence. Owner FEES JOHN HAZARD & DARLINE HAZARD type amount by date recpt 12040 SW ROSE VISTA DRIVE PRMT $ 25.00 DLH 06/12/98 98- 306474 TIGARD OR 97223 5PCT $ 1.25 DLH 06/12/98 98- 306474 Phone #: 639 -9561 Contract or: -- JOHN 0 BRANCH FIREPLACES & MOR JOHN OSCAR BRANCH - - -- PO BOX 23698 $ 26.25 TOTAL TIGARD OR 97281 Phone #: 620 -0255 Reg #..: 003958 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 Final Inspection 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 by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 - 'x':80. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -9187. Issue By: _ 0,/ i • Permittee Signature: OV /_,, ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ 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 i z TIGARD, OR 97223 Date to P.E. (503) 639 -4171, x304 a Date to DST Print or Type U JC. Li Permit # /1EC9,F - Gaaa Called Incomplete or illegible applications will not be accepted Name of Development/Project Description M4-.2.4_ A,a D Table 1A Mechanical Code DIY PRICE AMT Job Street Address Suite# A) Permit Fee -0- -0- 10.00 Address r „Z 6 X10 5 L'U IPOSE V/5 i4 Bldg# City/State zip 1.) Furnace to 100,000 BTU 6.00 1 ( Qe 97. 3 including ducts & vents Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50 Owner ,J6 f/ N 1 D,¢,L //I/F 1, 0 including ducts & vents Mailing Address 3.) Floor Furnace 6.00 I G' /l Q 3 Lv ROS E I/ / S TA including vent City /State Zip I Phone 4.) Suspended heater, wall heater 6.00 T 16-�,C J - , 97,2.... Z 3 or floor mounted heater Name (or name of business) 5.) Vent not included in appliance permit 3.00 5,�4y/G ,4s ,4 /34 UE Occupant of cling Address 6.) Boiler or comp, heat pump, air cond. 6.00 to 3 HP; absorb unit to 100K BUT City /State Zip I Phone 7.) Boiler or comp, heat pump, air cond. 11.00 3-15 HP; absorb unit to 500K BTU" Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00 To 11 /1) Q r e ,Q, firie,71, 15-30 HP; absorb unit.5 -1 mil BTU" Prior to permit Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50 issuance, a copy /S 7 7$ S u--) 9 F 30-50 HP; absorb unit 1- 1.75mi1 BTU" , of all licenses City tats zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50 are required if / / 6A--eo e 'g77a/ 42o z'bZ 9� > 50 HP; absorb unit 1.75 mil BTU" expired in COT Oregon Const. Cont. a uc.# Exp. ate 11.) Air handling unit to 10,000 CFM 4.50 database 395P ` yo .0, 9 Architect Name 12.) Air handling unit 7.50 10,000 CTM+ or Mailing Address 13.) Non - portable evaporate cooler 4.50 Engineer City/State Zip - Phone 14.) Vent fan connected to a single duct 3.00 Describe work New 0 Addition 0 Alteration.' Repair 0 15.) Ventilation system not included 4.50 to be done Residential 0 Non - residential 0 in appliance permit Additional Description of work: 16.) Hood served by mechanical exhaust 4.50 17.) Domestic incinerators 7.50 6,k ,.o 6- I N s Fe T Existing use of 18.) Commercial or industrial 30.00 building or property type incinerator 19.) Repair units 4.50 Proposed use of 20.) Wood stove 4.50 building or property 21.) Clothes dryer, etc. 4.50 Type of fuel - oil 0 natural gas, LPG 0 electric 0 22.) Other units ( 4.50 , I hereby acknowledge that I have read this application, that the information 23.) Gas piping one to four outlets 2.00 given is correct, that I am the owner or authorized agent of ` the owner, that plans submitted are in compliance with Oregon State laws. 24.) More than 4 -per outlet (each) .50 Signature of Owner /Agent Date 'SUBTOTAL °0 -- t ;€ - - 6 � -;;5- -7,p_- 91' 5% SURCHARGE ''�?, . / a 5 Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL ' -'i Y t' a¢ ' . ', ,; k // • Required for all commercial permits only _ . ,, l . ,. -,a_v y"1ikf ,f� I'�� / /o .7 g - ?J %/ TOTAL ; _a � - -. Q r!o • A5 'Minimum permit fee is $25 + 5% surcharge "Residential NC requires site plan showing placement of unit. 1:lmechprmt.doc rev 4/15/98 • Page No. 1 CASE HISTORY FOR CASE NO.: MEC98 -0222 JOHN HAZARD & DARLINE HAZARD • 12040 ROSE VISTA DR 10/08/98 Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd • Code Sent Done Done Date By MECA007 Application received / / / / 06/12/98 RECD DLH 06/12/98 DLH MECA008 Create Permit . / / / / 06/12/98 DONE DLH 06/12/98 DLH MECA060 (F) Issue permit / / / / 06/12/98 DONE DLH 06/12/98 DLH MECA705 Gas Line Insp 06/12/98 / / 07/02/98 Only 9 psi on gas line FAIL WDJ 07/02/98 WDJ • add a support to piping Replace union with a coupling. • MECA705 Gas Line Insp / / / / 07/08/98 Union cannot be in unexposed location. FAIL WDJ 07/08/98 WDJ MECA705 Gas Line Insp / / / / 07/15/98 Tag 304781 PASS KS 07/21/98 J *H MECA705 Gas Line Insp / / / / 07/31/98 REMOVE UNION AND VALVE TO GAS LOG, FAIL GS 07/31/98 GES LOCATION; JUST DOWNSTREAM OF "T" TO GAS • LOG PIPING. REPLACE W /LFT, RT NIPPLE AND COUPLINGS "REINSP FEE OF $30.00 CHARGED AT INSP DATED 7 -29 -98 IS WAIVED PER GS MECA715 Mechanical Insp 06/12/98 / / 07/02/98 Gas line failed. Gas log has not been FAIL WDJ 07/02/98 WDJ installed yet. • MECA799 Final Inspection / / . / / 07/06/98 8 lbs psi, needs 10 psi - manf. manual FAIL PDC 07/07/98 J *H MECA799 Final Inspection / / / / 07/21/98 Approved as noted: PASS KS 07/29/98 J *H 1. Seal around gas piping penetrating masonry fireplace with hi -heat furnace cement. • 2. Damper has been blocked in open position. 3. Gas piping PT test = 25 psi for 15 minutes (tag) #304781. 4. Installer to check for leaks when connection is made to supply source. ## #NOTE: Should not have been approved. Changed status to FAIL. See inspection report of 072298 & 072998 (per HAP). # ## MECA799 Final Inspection / / / / 07/29/98 Re- inspection fee assessed $30.00. $ 30 RB 07/29/98 RB 7 -2., 7 -6, 7 -8, 7 -15, 7 -22 and this date failed inspections w/o re- inspect fee charged. Failure to comply with Code req'mts re: placement of shut -off valve on supply branch line to furnace. MECA800 Case Finaled / / / / 07/21/98 PASS KS 07/21/98 J *H CITY OF TIGARD BUILDING INSPECTION DIVISION 6_,ST ,24 - Hour Inspection Line: 639 - 4175 Q G Business ne 639 - 4171 BUP 24// 3 T Date Requested? olq [ 0 A M — - / PM BLD Location [2-0 dw Pe) 4 (/ C4 & -Suite 410 r (JCL Contact Person _ Ph 6 367 -5'p/ 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 IKY S L.e, /■, S Insulation /4 e Lou-- '� Drywall Nailing // 1N Firewall Fire Sprinkler / 4.2 / ` 9 ' P ( .1 v \ Q 2 ) Fire Alarm / / g 1 , , F Susp'd Ceiling Alarm -7/ a W Miso Misc: -7/1C/9 bpi --S Final 7/22 -V q • V.-_S PASS PART FAIL PLUMBING y C..R._.-- Ws s � � s�� Post Slab rl t & Beam cO • (— - `` `J,._.v --Q -- C_QA. Top O Water S \d1/4.) ■ T � c ' ��� Water Service Sanitary Sewer Rain Drains \ _ _ v� l�C--e_ d O Final J 1/�J\ -- U vim./( L.).--k_ 4- 1r•-- S PASS PART FAIL Pos T B e a CAL X S G S_ 1-.3 AAA Rough In L :.v‘....12 .sLC ASS N Gas Line Dampers 7 6 .12 42 PASS PART FAIL a *" 04..vc `U G ELECTRICAL I' Service . U.5 t S a- • Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer tal _ "' Storm Drain [� einspection fee o'f� re_quired before next 'nspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin [ p Y p Fire Supply Line Please call for reins ection RE Vu�� 'v t-"r l tenable to inspect - no access ADA Approach /Sidewalk � 7 Other Date / Z 7 G / Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2 Ho1ir Inspection Line: 639 -4175 Business Line: 639 -4171 BUP ?-1// 7 Date Requested 7 , 410 K PM BLD Location 1 oQ & v (4t Suite MEC ? Contact Person /_/t aa .__i / ' Ph p PLM Contractor LW/it (2 BL Ph 63f ! D / SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab , ,,.,,�p/� M SIT Post & Beam t j7/ �'. ao G ge o '�1.V v ��L. s � Ext Sheath /Shear %l'1�(Q Y V Int Sheath /Shear Framing Insulation J Drywall Nailing Mt 1L•41 Yc- Avir Firewall Fire Sprinkler / . set.1 ,4Q- Fire Alarm Susp'd Ceiling T ��s �5. I Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final FAIL ECHANICAL Post & Beam Rough In • 6 Gas Line / HI Smoke Dampers rna P SS PART AIL 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 Other Date j Inspector Ext Final PASS PART FAIL . DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION IY MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested a ®' ' AM PM BLD Location /?L9 1i1 --J �15 04_, . Suite ( � )S '02-2%7-- Contact Person Ph PLM Ge r i Ph 6,077 O 3 a SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: /�/ 441 Slab l'�.�i Post & Beam Ext Sheath/Shear im —� ? t P1 r- Int Sheath /Shear Framing Insulation 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 P r FAIL Post & Beam Ro S e Dampers PAS ART 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 Date '� - 2 — le . / /��q E x t Other p Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.