Permit { CITY OF TIGARD MECHANICAL PERMIT
/er+Y;,,: DEVELOPMENT SERVICES PERMIT #: MEC2000 -00382
' ' �' I � 13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/26/00
PARCEL: 2S103CC -01700
SITE ADDRESS: 11990 SW ROSE VISTA DR
. SUBDIVISION: COLONIAL VIEW ZONING: R -4.5
BLOCK: LOT: 012 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: OTHER UNITS: 1
GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas fireplace.
Owner: FEES
ZIMMERMAN, LIN A • Type By Date Amount Receipt
KATHERINE L PRMT CTR 9/26/00 $72.50 2720000000
11990 SW ROSE VISTA DR 5PCT CTR 9/26/00 $5.80 2720000000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
LUDEMAN'S FIREPLACE + PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005 -2129 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 646 -6409 Mechanical lnsp
Reg #: LIC 51469 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 may obtain copies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: i 2 , ' ,- Permittee Signature: --7M.,/ z
Call (503 639 -4175 by 7:00 P.M. for inspections needed the next business day
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` .( Plan Check #
CITY OF TIGARD M echanical Permit Application /( Reed By .P
1312': SW HALL BLVD. Commer and Residential 1 Data Red
_ TIGARD, OR 97223 RECEIVED D to P.E.
(503) 639 -4171, x304 Print or Type Date to DST
Incomplete or illegible applications will not be S� C c@p� t e� _OPermit I
Called
COMMIINITY nE "E-OPMENT -
Name a 1 e Tbcription
Ts 1A Mechanical Code Qty Price Total
Job _ / �',,' I �j�/ 0/ 1) Furnace to 100,000 BTU
Address I t R [Q d �v " b r" ,, � 2) po 14.00 mace 00,000 BTU+
Bldgrr Cay� ( including ducts & vents 17.40
t om ! ] 3) Floor Furnace
Name (or nano of business) including vent • 14.00
Owner LI Al ZM,ti1trA 1- 4 ) Suspended heater, wall heater
or floor mounted heater • 14.00
Mailing Address
l iq' o 51.0 osim 5 bri u 5) Vent not included in appliance permit 6.80
1( 6 G Phone
j 0e-q-122-3 /_� 3b ' 6) Repair units , 12.15
► l�lJ (O O Check all that apply: . 'Boiler Heat Air
Name (or name of business) For items 7 -10, see or Pump Cond Qty Price Total
i _ footnote.; 1,7 , Comp ..
Occupant wthngAddrew 7) <3HP: absorb unit to ,
100K BTU 14.00
City/Stale Zip 111 p 8) 3 -15 HP; absorb unit
I 100k to 500k BTU 25.60
` 9) 15-30 HP; absorb
Contractor tie r unit .5-1 mil BTU 35.00
i x,,11 Pro 5 Feeki PA TO 10) 30-50 HP: absorb
Q+g Address unit 1 -1.75 mil BTU 52.20
Prior to permit
issuance, a I fl S -«� I' �cj 1 1) >50HP; a bsorb unit >1.75 mil B
coPY 87.20
of all licenses c f syate Zip Phonkje/3 12) Air handling unit to 10,000 CFM
are required if .. &/"f'0 Y' O 21 b � / 10.00
expired in COT t ItI2on Cans. cant eoe a t.ic.a Exp. Date 13) Air handling unit 10,000 CFM+
database 5 P164 -?er 3 oL 17.20
Architect Name 14) Non - portable evaporate cooler
10.00
15) Vent fan connected to a single duct
or Mailing Address 6.80 i
16) Ventilation system not included in
Engineer City/State Zip Phone appliance permit 10.00
• 17) Hood served by mechanical exhaust
10.00
Describe work to be done: 18) Domestic incinerators
17.40
New 0 Repair 0 Replace with like kind: Yes)No 0 19) Commercial or industrial type incinerator
Residential Commerciei O . Modification O 69.95
Additional information or description of work: 20) Other units, including wood stoves
• 1 10.00 10.
NOTE: For Corrunercial projects only, Units over 400 lbs., located on the 21) Ga pipin one to four outlets
~ 4D
roof, require structural cats. prepared by licensed engineer. 5.40
Type of fuel: oil 0 natural gasX LPG 0 electric 0 22) More than 4-per outlet (each) 1.00
Minimum Permit Fee $72.50 SUBTOTAL J , x.•4;
I hereby acknowledge that I have read this application, that the 8% SURCHARGE .Hi=' , ''' - S
information given is correct, that I am the owner or authorized agent of _ - t
SUBTOTAL the owner, that plans s are in compliance with Oregon State .N - T.
�` ,l'� Q„t 6 % Re q u ired tor ALL cow PL AN REVIEW 25% OF SU ciai permits only ,..:::.,:fn..
�: g.3o
f r /Agent 4,t ate TOTAL ^ °4 ~wV -.,� •
iture
• K. cc 14 8 ,� �4 -t t , Other Inspections end Fees:
/ ( I. Inspections outside of normal business hours (minimum charge•rwo hours)
tact Person Name Phone :72.50 per hour our
5 3 Y6 YO 6 9 2. Inspections for which no fee is specifically indicated (minimum charge-half hour)
S72.50 per hour
Footnotes for commercial protects only: 3. Additional ptan review requ by changes. additions or revisions to plans (minimum
1. Provide fun schematicd existing and proposed gas tare and pfessure. charge-one-had hour) 572.50 per hour
2. Provide drawings to scats showing existing and proposed mechanical State Contractor Baler Certification required
unds. ' NC requires site plan showing placement of unit
I :ldstsVorrnSbnechperm_rev.doc 9/8/00
CITY-0/1 TIGARD BUILDING INSPECTION DIVISION 6 - -
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested / — AM PM BLD
Location l /rf 9 Suite MEC uti—GO 31Z�
Contact Person Ph i- ZG 34 ee 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 1 C tc I ° i Ai S &X[ 37 i /""rMSr
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
RT FAIL
ECHANICALT
Post & Beam
Rough In
Gas Line -
Smoke Dampers
PAS PART 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 /
Other D / —— Ins Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.