Permit -~ �T CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2000 -00224
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: PARCEL: 1 S13 1 S13 06/07/2000
3DC -14200
SITE ADDRESS: 13122 SW SHORE DR
SUBDIVISION: ARI GREEN ZONING: R -12
BLOCK: LOT: 033 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> GAS OUTLETS:
10000 cfm:
Remarks: Installation of air conditioning unit in single family dwelling.
Owner: FEES
MOORE, JEFFREY K + LINDA M Type By Date Amount Receipt
13122 SW SHORE DR PRMT KJP 06/07/200 $50.00 0002758
TIGARD, OR 97223 5PCT KJP 06/07/200 $4.00 0002758
Total $54.00
Phone:
Contractor:
SPECIALITY HEATING + FABRICTN
9528 SW TIGARD
TIGARD, OR 97223 REQUIRED INSPECTIONS
Cooling Unt Insp
- Phone: 620 -5643 Final Inspection
Reg #: LIC 00066578
ORIGINAL
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 -91
Issue By: c ) Permittee Signature: „� .v�.,}k -c,, I r
Call (503) 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
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to D,�S TD,�
Print or Type Permit #1 "�
Incomplete or illegible applications will not be accepted Called
Nam of Oevelopment/Project Description
Nam
4064.�� Table 1A Mechanical Code Qty Price Amt
Job �_ SGGeet Address Suae# _A) Permit Fee d 16.00
Address /az SW S4Ore le 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
( 690-'l 7.2.-2- including ducts & vents see footnote 1,2 12.00
Nam (or name of busines 3) Floor Furnace
Owner ii»,4 /p`fl?-C...- including vent see footnote 1,2 9.65
ding Address 4) Suspended heater, wall heater
2 /G1)- 5 � 5 ` cre ie or floor mounted heater see footnote 1,2 9.65
cJ /� ,(/ 5) Vent not included in appliance permit 4.75
•
City/State Zip Check all that apply: *Boiler Heat Air
/ ! �1 Di t 72, a ._ 7 For items 6 -10, see or Pump Cond • Qty Price Amt
Ne a (o name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
d/�' - 100K BTU 9.65
Occupant Mai ing Address 7) 3-15 HP;absorb unit
100k to 500k BTU "' 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Contractor Name . 9) 30 -50 HP; absorb
unit 1 -1.75 mil BTU 36.00
,S o-eC I / 10) >50HP; absorb unit
Prior to permit Mai g Address ,---- >1.75 mil BTU 60.15
issuance, a copy qsa Zs" 6 //9a46/ 11 Air handling unit to 10,000 CFM
of all licenses State // zie Phone ...145__? 7.00
are required if 0 ■ q2a GM 'SG s 12) Air handling unit 10,000 CFM+ •
expired in COT Oregon Cosist. Co Cot. Board Lic.# Exp. Date 11.85
database lP (-.7f' 5/o/ 13) Non - portable evaporate cooler
Architect Name • 7.00
14) Vent fan connected to a single duct
or Mailing Address 4.75
15) Ventilation system not included in
• appliance permit 7.00
Engineer City /State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
• 12.00
New 0 Repair 0 Replace with like kind: Yes O No O 18) Commercial or industrial type incinerator
Residential Commercial 0 48.25
19) Repair units
Additionation or� of work: 8.40
C.,-
•. 20) Wood stove /gas FP /other units /clothe dryer /etc.
[[[ 7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets .
structural gas calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL 4egieUitag0 5�
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE , " <?'
given is correct, that I am the owner or authorized agent of PLAN REVIEW -25% OF SUBTOTAL' ,' : `''
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only ° n r t
P P e9 TOTAL ,r : ?, `a'; :. ` "r t� in
Signature f Owner /Agent Date
41,1(ZU/1/(-- j , Other Inspections and Fees:
6
//j1) 1. Inspections outside of normal business hours (mininum charge -two
Contact Pe Name Phone 111 hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
�j)3Ad o - S,g? charge -half hour) $50.00 per hour
Foon es for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge-one-half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. 'State Contractor Boiler Certification required
- Residential A/C requires site plan showing placement of unit
l :lmechperm.doc rev 7/19/99
I ?")614 M5',11c1
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A
/2'4 a)I
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested WN) AM PM BLD
Location ( 122 Sln,a)`2_ QK' Suite , MEC "7,0 Y
Contact Person /�acs/ ., (J Ph IOZd —S� `R PLM
Contractor Ph SWR ZO,ru
BUILDING Tenant/Owner ELC Z- 00 202
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
Insulation
Drywall Nailing
Firewall L�
Fire Sprinkler `J 2--o
Fire Alarm
Susp'd Ceiling
Roof / -
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab /4/l/f �
J - - LW
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
-
Pos
Rough In
Gas Line
Smoke Dampers
A S .ART FAIL
Serve
Rough In
UG /Slab
Low Voltage
Fire Alarm
5D 'ART FAIL
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
Other h /Sidewalk 2 .. /j - -ti-��l
Other Date L LJ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.