Permit A, CITY OF T MECHANICAL
/4 „4, I \ DEVELOPMENT SERVICES PERMIT
-�! J. °''� �l
.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # • MEC98 -0330
DATE ISSUED: 08/10/98
PARCEL: 1S134BD -06800
SITE ADDRESS...: 11725 SW SPRINGWOOD DR
SUBDIVISION • ENGLEWOOD NO.2 ZONING: R -4.5
BLOCK • LOT •156 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE -SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/O 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
FURN < 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Alteration to residence.
Owner: FEES
TONY MCCORMICK type amount by date recpt
11725 SW SPRINGWOOD DR PRMT $ 25.00 DLH 08/10/98 98- 308146
TIGARD OR 97223 5PCT $ 1.25 DLH 08/10/98 98- 308146
Phone #: 590 -6464
Contract or:
B & T GAS SERVICE INC
KEITH TEASDALE
8528 SW 190TH AVE $ 26.25 TOTAL
BEAVERTON OR 97007
Phone #: 642-7243
Reg #..: 000911
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 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 nay
obtain copies of these rules or direct questions to OUNC by calling
1503)246 -9187.
Issue By: Permittee Signature: / E t
-- ez/ /97A';, e 9 -Tar/
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
• Plan Check #
CITY OF TIGARD Mechanical Permit Applic do l a , Recd By /..-/-/ 13125 gW HALL BLVD. Commercial and Residentia Date Recd R //0/9
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 AUG IaQ Date to DST
Print or Type co, ..,ui:Ir y �„ ,,,, i, ,;_,
Permit # /`ZEZ' ?"--- ®.3 3 b
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address . Suite# A) Permit Fee -0- -0- 10.00
?
Address iia 5i� S eriny ►
Bldg# City /State zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents
Nam (or name of business) • 2.) Fumace 100,000 BTU+ 7.50
Owner l U/ki Me Coa-rn I including ducts & vents
Mailing Add s ., CC • u'_,,I 3.) Floor Furnace 6.00
/)
I I 3 (n-) J p r l f1c (AA 2 I 1 De• including vent
QiI.State zip Phone 4.) Suspended heater, wall heater 6.00
/ i (3p OR ) , (J R q ! �1 o3 !/O li'!7(0'1 - or floor mounted heater
Name (orar,1 - e busin 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
3-15 HP; absorb unit to 500K BTU"
Contractor Name .. _ 8.) Boiler or comp, heat pump, air cond. 15.00
. Ga s Se-�1iC.L ,9rc 15-30 HP; absorb unit5-1 mil BTU"
Prior to permit Mailing Address,
C 11_ 111/1/) 9.) Boiler or comp, heat pump, air cond. 22.50
<
issuance, a copy 5�� J� 19&" /7 30-50 HP; absorb unit 1- 1.75mi1 BTU"
of all licenses /State j Zip Phone u 10.) Boiler or comp, heat pump, air cond. 37.50
� ��
are required if )) OR_� - 7� /99c) 7� !3 > 50 HP; absorb unit 1.75 mil BTU"
expired in COT Oregon Cons / uc.# o6 D ot vc? 11.) Air handling unit to 10,000 CFM 4.50
database �/L /
Architect Name 12.) Air handling unit 7.50 ,
10,000 CTM+
Or Mailing Address 13.) Non - portable evaporate cooler 4.50
Engineer City /State Zip Phone 14.) Vent fan connected to a single duct 3.00
Describe work New 0 Addition 0 Alteration 0 Repair 0 15.) Ventilation system not included 4.50
to be done Residential 0 Non - residential 0 in appliance permit
Additional Description of work: 16.) Hood served by mechanical exhaust 4.50
17.) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial 30.00
building or property type incinerator
19.) Repair units 4.50
Proposed use of 20.) Wood stove 4.50
building or property
21.) Clothes dryer, etc. 4.50
•
Type of fuel - oil 0 natural gas 0 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 2.00 ^
given is correct, that I am the owner or authorized agent of of ,
the owner, that plans submitted are in compliance with Oregon State laws. 24.) More than 4 -per outlet (each) .50
Signature of Owner /Agent Date *SUBTOTAL , ,• - •; ,, �� OO
n
n ,J /1 O �/
/07/9 (1 5% SURCHARGE • i 0
Conta Perso a me , `(M ! Phone D PLAN REVIEW 25% OF SUBTOTAL , . - : I
1l �/ / Q ��� n � q Required for all commercial permits only.
Y SIC rlil IV/ TOTAL - '-
/ � 2c'
'Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit.
I: \mechprmt.doc rev 4/15/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
.,' I P ��/l�C BUP
tc) Date Requested S ' )4 -93' AM /BLD
Location /1 7.. S SA) ZrV GL Suite ?i - 3i
Contact Person y� ( Ph 70<43 PLM
Contractor 3 (r �r,- Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation I 6 'I _ 1 A 1. FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation //�� I
Drywall Nailing V�7O 5 t Y1_ @ ✓L 3
(3
Firewall
Fire Sprinkler
Fire Alarm f
Susp'd Ceiling
Roof —�
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam •
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
! _MECHANICAL
Post & Beam
Rough In
Gas Line
S • ke Dampers / v 5" lw-ctt
PART
CTRICAL •
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 Su ply Line [ ] Please call for reinspection RE: �j nable to inspect - no access
P
ADA
Approach /Sidewalk Date 2 C 1 4 6 Ext r / l
Other In AiaAA0/1.---
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.