Permit CITY O TIGARD
MECHAN I CAL
DEVELOPMENT SERVICES PERMIT
PERMIT # MEC98 -0532
!+L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11 / 24 / 98
PARCEL: 15135BD -00900
SITE ADDRESS...: 09770 SW SHADY LN
SUBDIVISION • ZONING: C —G
BLOCK LOT • JURISDICTION: TIG
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 • 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.: 0
FIJRN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN ) =100K BTU: 0 > 10000 cfm: 0
Remarks : Beaverton Tigard Insurance outdoor gas pack
Owner: FEES
BEAVERTON TIGARD INSURANCE type amount by date recpt
9770 SW SHADY LN PRMT $ 25.00 JSD 11/24/98 98- 311063
TIGARD OR 97223 PLCK $ 6.25 JSD 11/24/98 98- 311063
5PCT $ 1.25 JSD 11/24/98 98- 311063
Phone #:
Contractor:
ABLE HEATING & COOLING INC
12420 SW SUMMERCREST DR
$ 32.50 TOTAL
TIGARD OR 97223
Phone #: 579 -2250
Reg #..: 001085
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. Rll 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- 001-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
obs
Issue B 41111 P e r m i t t e e A , i / L.
++++++++++++++++++++++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
11/04/98 WED 09:49 FAX 503 598 1960 CITY OF TIGARD IJ002
'CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential • Date Recd / /z/j •
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
• Print or Type Permit# !�� — c )?
Incomplete or illegible applications will not be accepted Called n1 d� D
. Name of oevelopment/Proteu Description l ` l
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suites A) Permit Fee 10.00
Address °17 70 5tv. 31 V' v 1) Furnace to 100,000 BTU
including ducts & vents 6.00 4rrp'U
etdgtt Cdy/State ap
d u l t r 97� 2) Furnace ducts & vents 7.50
0 BTU+
including duds
e (or name of busin ) t 3) Floor Furnace
Owner 7 --/�A )1 Su vent 6.00
4) Su spended heater, wall heater
G f i,V
Mal g Address a
or floor mounted heater 6.00 •
rr •eft.rt2--- 5) Vent not included in appliance permit
city/state Zip Phone
_ 3.00
X 230 CHECK ALL 'Boiler Heat Air
Name (or name of business) THAT APPLY: or Pump Cond Qty Price Amt
_ Comp
6) <3HP;absorb unit to .
. .Occupant Mailing Address 100K BTU - 6.00
7) 3-15 HP ;absorb unit
• City/state Zip I phone 100k to 500k BTU • 11.00 •
8) 15-30 HP; absorb
unit .5-1 mil BTU 15.00
Contractor 9) 30 -50 HP; absorb
Na
Q 4, .( si j(/G t unit 1 -1.75 mil BTU 22.50
Prior to permit i r ess ^ .10) >50HP; absorb unit 7 issuance, a copy 4 2g g Sa , ,jT . >1.75 m il BTU 37.50
of all licenses yy $/ g iP . 1 1) Air handling unit to 10,000 CFM
expired required
n COT Oregon (o tst C. ■i, , l 12) Air handling unit 10,000 CFM+ • 4
database. (# ' 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 I Phone appliance permit- • 4.50
16) Hood served by mechanical exhaust •
Describe work to be done: 4.50
• • 17) Domestic incinerators •
New Repair 0 Replace with Ike kind: Yes 0 No 0 7.50 .
Residential 0 CommerdalAt, 18) Commercial or industrial type incinerator
30.00
Addition information or desclipti of wo 19) Repair units
.C. 4.50
20) Wood stove
4.50
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gasp, 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
given.is come- .• •t I am the owner or authorized agent of 2.00 • _ •
the owner i at pla submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each) f
. 50
• • Sl c ., - r /Agent A �, Date: =,- •'* , • atone �tir Minimum Permit Fee $25.00 SUBTOTAL y ' =r• - 6r •• - ,
��I ,� /� i `� 5% SURCHARGE `.! a,, •'.- -,
ontact • n Name Phone - PLAN REVIEW 25% OF SUBTOTAL ' I" V _ .' -0
Required for ALL commercial permits only r .r =?? c., ' i::
TOTAL - - . I
'State Contractor Boiler Certification required
• ' "Residential NC requires site plan showing placement of unit / A �
. I:Vnechperm.doc rev 07/20/98 O� • P ` // VV
ce
.
- . ROB J421 KN 2yiZL . 6 p Rhtc
'. Heati and Cooling Air Conditioning Site Plan
Customer sQ�dl
Address �J770 �,4L stiff Lo C T
City �11 A4 I zip - . -
y
Mvlielii PG Alp - 75-/
? r e rky C n1E
•
Q , c Agi iimniG 3 uQ s}Aites
•
014- I ;y
, over
uokr —
. 33 , 14 .,
0(ille ,
CITY Or TIGARD , "
Approved . c
V
Conditionally Approved .
For only the work describe�¢y,
PER/I 1T 1'10 ___11 C- `7 -- O'- Z
•
See Letter to: Follow ( ♦ QIggeeir l iA!B
Job Ad. s / ' _ , L ,- .
By: 40) ( �� ' Date: .././..e.
\ sue► Dy I. 4 —
, BL' Heating and Cooling - New Installation Order Form I Date
Customer Hm.Ph. Vk.Ph.
Job Address ? • City , Zip
Billing Address City Zip
check one: • 0/0 0 I 0/0 Q E/G '0 j B/B (] OTHER Q
Equipment List: yes no Mod. number ' ` ' k
Furnace
Condensing unit
Coil
Line set length
Space Gard
Thermostat
Condensate pump
Pad
Other •
Flat Rate Item Hr. Flat Rate Item Hr.
1. 4.
2.
S•
3 • total hours
Reclaim Freon
yes Q no 0 Water heater OWN 0 ERN Q
Panel Make Spaces available yes a no 0
Sani -Vac Service
Yes Q no Q Planned Maintance yes 0 no Q
- i upf low Q f
downflov 0
vent size
t I location
� i I
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
1 08 of �/ n p BUP
Date Requested /a �0 AM PM BLD
Location / 7CJ Suite MEC
Contact Person G�/ (/)/ ' �� / - Ph) �/ (J�470 PLM
Contractor Phi, 5 ? - 5 SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation / n / I / • FPS
Ftg Drain /l!,{�/ l /�� V 1F/1l Crawl Drain Ins • - •4io N •tes: SGN
Slab L(I! / t/0 ,co
SIT
Post & Beam [ , " <i/
Ext Sheath /Shear �
( / Q.4A/ �/ �7 -
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling Z t sr � 1�i >'? � / 7--
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PADS - -PAR'S FAIL
M ECHANICAL \)
Post &Beam
Rough In
Gas Line
•ke Dampers
— 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-
Inspector
Other Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.