Permit CITY OF T MECHANICAL
•
�, . DEVELOPMENT SERVICES
I'I
+L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT
PERMIT #
• MEC97 -0307
ISSUED: 08/14/97
PARCEL: 1S135BD -01200
SITE ADDRESS...: 09804 SW SHADY LN
SUBDIVISION • ZONING: C —G
BLOCK • LOT . JURISDICTION: TIG
CLASS OF WORK..:REP FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES • 0 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 < 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Replacement of like -kind gas pac unit on roof.
Owner: FEES
NW COMMUNICATIONS type amount by date recpt
9804 SW SHADY LN PRMT $ 25.00 DRA 08/14/97 97- 298275
TIGARD OR 97223 SPCT $ 1.25 DRA 08/14/97 97- 298275
Phone #:
Contractor:
ROBBEN & SONS HEATING
2300 SE 7TH AVE
P 0 BOX 14867 $ 26.25 TOTAL
PORTLAND OR 97214
Phone #: 233 -5841
Reg #.. : 001884
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection
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 - 01-0010 through OAR 952-001-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(5031245 -9187. ___ dor
Issu B Permittee Si nature: _. //
Y 9
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Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
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CITY OF TIGARD Mechanical Permit Application Rec'd By a kJ
13125 SW HALL BLVD. Commercial and Residential Date Recd 9 -/ l/ "Q
TIGARG;' OR 97223 Date to P.E.
(50 Date to DST �-
) 639 -4171, x304 Permit# 1 tc('_-Q - 2 -0307
Print or Type celled
Incomple.e or illegible applications will not be accepted
N: •: - •f Dave •.. e •ro( - -. Description
�� Table 1A Mechanical Code CITY PRICE _AMT
Job Address /! Surte8 A) Permit Fee -0- -0- 10.00
Address 9/o 47/x✓; ■ , . , .. -
Bldg0 City /Sla - Zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents
Name or name of business) 2.) Furnace 100,000 BTU+ 7.50
•
Owner including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
including vent
City/State Zip 1 Phone 4.) Suspended heater, wall heater 6.00
or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
•
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT" '
City/State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
Q
3-15 HP; absorb unit to 500K BTU"
Contractor N 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to y 15-30 HP; absorb unit.5 -1 mil BTU"
issuance aili A ress 9.) Boiler or comp, heat pump, air cond. 22.50
applicant , .) / 1 FC 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all City / a z ip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor 4:C f 7 /e/ g7j -5 > 50 HP; absorb unit 1.75 mil BTU**
license regon Con . Board Licit Exp. Date 11.) Air handling unit to 10,000 CFM 4.50 •
information /� c�
for COT COT to a r�evo a Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database).
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00 -
Engineer City/State Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional Description of work Domestic incinerators 7.50
f 18.) Commercial or industrial type 30.00
4 ' �� <'> Incinerator
a '. ng use of 19.) Repair units 4.50
building or property '
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. - 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas, LPG 0 electric 0 23.) Gas piping one to four outlets 2.00
I hereoy acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, tha • ans . ubmitted are in compliance with Oregon State QTY. SUBTOTAL C1 [_ -•
laws. � •
Signature •f Owner i. t Date *SUBTOTAL
" A /v 77 5% SURCHARGE
Contact?. rson Name Phone PLAN REVIEW 25% OF SUBTOTAL //
TOTAL c /.,
i:ld st\mechpmtdoc (rev 9 *Minimum permit fee is 525 + 5% surcharge p � (f �
"Residential A/C requires site plan showing placement of unit.
L - r7 - 07-70
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
50// Date Requested o2 - 3/ - 9 AM X IPA 1 BLD
Location Vo4 St ( 9 Suite 7 7"0 3O7
Contact Person d Ph o.233-,51i1 PLM
/ /
Contractor 4 It SO A_ Ph
SWR
BUILDING Tenant/Owner J � _ ar 7 ret. _, ELC
Retaining Wall / / ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam / , /
Ext Sheath /Shear ) // 4 g/tic 1 x
/ '',
Int Sheath /Shear
Framing
Insulation / F-
Drywall Nailing ( 2r - C/\t _ l.
Firewall
Fire Sprinkler W7 ti-- ZS p ��
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
FAIL
p,MECHANI
Post & Beam
Rough In
Gas Line
_Smoke D .0)• --
Final
c PAS PART FAIL
tfC T RICAL
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
A roach /Sidewalk
Other Date 10\ 6 Inspector � ` Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.