Permit 4 CITY OF TIGARD
MECHANICAL
PERMIT
—14- 1i�,, DEVELOPMENT SERVI DATE ISSUED: 03 /3Q -0131
PARCEL: 25110CD -00102
SITE ADDRESS...: 15340 SW ROYALTY PKWY
SUBDIVISION • KING CITY NO. 2 ZONING:
BLOCK LOT :002 JURISDICTION: KIN
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 1 BOILERS /COMPRESSORS HOODS : 0
FUEL TYPES 0 -3 HP • 1 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.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Install a new gas line and push pull heating and a/c unit.
Owner: FEES
JOE MCCAHAN type amount by date recpt
15340 SW ROYALTY PARKWAY PRMT $ 25.50 DLH 03/30/99 99- 314081
TIGARD OR 97224 PLCK $ 6.38 DLH 03/30/99 99- 314081
SPCT $ 1.28 DLH 03/30/99 99- 314081
Phone #:
Contract or:
GOHMAN MECHANICAL INC
20980 S GOULD CT
$ 33.16 TOTAL
OREGON CITY OR 97045
Phone #: 650 -1588
Reg #..: 119952
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 Duct Inspection
approved plans. This permit will expire if work is not started S.D. Shut —d o w n
within 180 days of issuance, or if work is suspended for more Misc. Inspection
than 180 days. ATTENTION: Oregon law requires you to follow rules Final Inspection
adopted by the Oregon Utility Notification Center. Those rules are Final Inspection
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 By:
4
_ Permittee Signature: ata et - -
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + ++ + + + + + + + + + + + + + + + + + + + + + + + ++
.• CITY -OF TIGARD Mechanical Permit Application RPlan ecd By Check -
By
13125 SW HALL BLVD. Commercial and Residential Date Recd 3
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST 3 Q 4 'if
Print or Type Permit# /ate cl '
Incomplete or illegible applications will not be accepted Called 3 -30-
Name of Development/Projed Description
.131 & BL \ a .% l Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 10.00 5
Address J T
1 3 Lj ® Ski R® 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 6.00
Bldg# City/S A (?�t Zip 2) Furnace 100,000 BTU+ SU
f [a ^
including ducts & vents see footnote 1,2 1 7.50 ` I J
Name (or name of business) 3) Floor Furnace
Owner St7e MCC MC A h Ib-t■-9 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
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
VA /� G � footnotes 1,2 Comp �'
V 6) <3HP;absorb unit to
Occupant Mailing Address 100K BTU 1 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
ih Dior) Mee/kart I 9) 30-50 1-1.75 HP; absorb
permit ailing Address - '"� �L - unit 1 -1.75 mil BTU 22.50
Prior to
pe 9 10) >50HP; absorb unit
issuance, a copy p S , 6120....4.1.01 >1.75 mil BTU 37.50
of all licenses City /State �� Zip Phone 11) it handling unit to 10,000 CFM
are required if ox C 17'6 i OK. -! 70(65 (p.I'I,j.� D 4.50
expired in COT Oregon Const. Contoard Lic.# Exp. Date 12) Air handling unit 10,000 CFM+
database / /'q 9 5 e I" 02 9 -°/ - 7.50
Architect Name 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 City /State Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
� 17) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes l9°No O 7.50
Residential 0 Commercial O' 18) Commercial or industrial type incinerator
30.00
Ad ' ional information or idescription of work: 19) Repair units
LASH 21.4. j I LAN 1-3 4.50
N CU- C't Pt S l_i i1 e • 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 gas G-- 0 electric O 4.50
22) Other units
I hereby acknowledge that I have read this application, that the information 4.50
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 0 2.00
24) More than 4 -per outlet (each)
Signature of Owner /Agent Date .50
/�
� Q ` ! Minimum Permit Fee $25.00 SUBTOTAL
Contact Person Name Phone
/Vr F \ 1t•N (%0 0� /Sca 5 % SURCHARGE
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
2. Provide drawings to scale showing existing and proposed mechanical » 33/
units. *State Contractor Boiler Certification required
"Residential NC requires site plan showing placement of unit
i:tmechperm.doc rev 02/4/99
•
02/17/2000 Activities for Case #: MEC99 -00131 .
2:49:59 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 03/29/1999 GEO RECD DST 03/29/1999
MECC008 Permit created 03/29/1999 GEO DONE DST 03/29/1999
MECC011 Routed to Plans Examiner 03/29/1999 GEO SENT GEO 03730/1999
MECC014 Plan checked /Approved by P.E. 03/30/1999 RDP APPR RDP 03/30/1999 •
• MECC015 Reviewed_Plans Routed to DSTS 03/30/1999 RDP APPR RDP 03/30/1999
MECC799 Final Inspection DST 03/29/1999
MECC705 Gas Line Insp 03/30/1999 05/13/1999 TLP PASS AKJ 05/13/1999 .
MECC706 Mechanical Insp 03/30/1999 10/05/1999 TLP NOTE AKJ 10/05/1999 mechanical system existing
MECC735 Duct Inspection 03/30/1999 RDP 03/30/1999
MECC745 S.D. Shut -down 03/30/1999 RDP 03/30/1999
MECC750 Misc. Inspection 03/30/1999 RDP 03/30/1999
MECC799 Final Inspection 03/30/1999 10/12/1999 GS . PASS JS 10/13/1999 See BUP1999- 00277. 10/12/99.
MECCO50 (F) Ready to issue 03/30/1999 GEO PASS GEO 03/30/1999
MECC090 (F) Issue permit 03/30/1999 DLH DONE DST 03/30/1999
MECA800 Case Finaled 10/14/1999 JMT DONE No Hold JMT 10/14/1999
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171 BUP Tq9 —��
Z�
Date Requested lt)-[ 2-/ ( AM PM BLD
Location 153 0 PA) uite MEC 99 - -- M3/
Contact Person PP S 3 R' ` Sr ) PLM
Contractor Ph SWR
ILDI Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT tgg9'co0g2.
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing ® 1, .c, �./� -
Y
Insulation
Drywall Nailing --12--7 � / �,n -rr-� �� `
Firewall /
Fire Sprinkler _
Fire Alarm -
Susp'd Ceiling OP `.4 / ' _.— � ,• -_` ,
Roof ✓ ,
c:
PASS PART FAIL .1�/ . _.s i. _AL_t -��/' • - '
PLUMBING ?, '
U e r Slab
U ab
./
ndr l
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CHAN C
Post & Beam
Rough In
Gas Line
Smoke Dampers
ia,
P • SS - ART FAIL / v.
S e -. I % - NIL � u1 k; d he -
ELECTRICAL
Service f � ' r' =7 ' ' " % "•
Rough In
UG /Slab da _�,•
Low Voltage
Fire Alarm
Final °�
PASS PART FAIL /
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reins ection 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 g et
Approach /Sidewalk Date /Q - / Z1 7 % Inspector 'el Ext
Other
ASS PART 11121111■ DO NOT REMOVE this inspection record from the job site.