Permit CITY OF T MECHANICAL
PERMIT
.4, , DEVELOPMENT SERVICES PERMIT # • MEC98 -0098
-' NI- 11. i, 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03/17/98
PARCEL: 1S134CA -00705
SITE ADDRESS...: 11915 SW SUMMER CREST DR
SUBDIVISION • BURLWOOD NO.3 ZONING: R -4.5
BLOCK • LOT -040 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/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
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 new gas furnace and gas line for an existing single family
dwelling.
Owner: FEES
WENDY WAGONER type amount by date recpt
11915 SW SUMMER CREST DR PRMT $ 25.00 GEO 03/17/98 98- 304166
TIGARD OR 97223 5PCT $ 1.25 GEO 03/17/98 98- 304166
Phone #:
Contractor:
MR FURNACE HEATING INC
16285 SW 85TH AVE
TIGARD OR 97223
EXPIRED 26.25 TOTAL
Phone #: 684 -9014
Reg #..: 000879
REQUI RED INSPECTIONS
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 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.
Issue By: _ / /L /% Permittee Signature < 4C
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 StV HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # /i/o $ - CO 5 2•
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
• Table 1A Mechanical Code OTY PRICE AMT
Job Street Address Suite# A) Permit Fee
Address II V S to . Sr(.a.+e.t�f ac. o- -0- 10.00
Bldg# City /State Zip 1.) Furnace to 100,000 BTU 6.00
Tic, pg kJ 4d k including ducts & vents
Name (or name of business) ! 2.) Furnace 100,000 BTU+ 7.50
Owner (J3 7 C(J 42 yO,. e°K including ducts & vents
Mailing Addres 3.) Floor Furnace
7 /.f , Le). s u i.He.v cy incuding vent
orl ,0ti. 6.00
Cityaiate /A Zip Phone 4.) Suspended heater, wall heater 6.00
/00 biz . Q70223 r ..2 / JY//.t or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
P r
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
i2 . r. p. c ti ,a 7�/ ,.. .� t . 15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit Mailing Address _ v .t t 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy /6a fr f w • F1 L '. .70) 30-50 HP; absorb unit 1- 1.75mil BTU"
of all licenses City /State • A Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if 7/ Jr cY 97 .t y Epp -90/7 > 50 HP; absorb unit 1.75 mil BTU"
expired in COT Oregon oust. Cont. Board Licit Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
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: 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
EXPIRED Incinerator
Existing use of B 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 0 LPG 0 electric 0 23.) Gas piping one to four outlets / 2.00
I hereby 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, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL - �
laws.
Signature of Owner /Agent Date /p *SUBTOTAL
b� `3Z 7/ ' f 5% SURCHARGE + 51- Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL /
TOTAL
i:Unechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit.
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour pe on Line: 639 -4175 Business Phone: 639 -4171
Requested: 3 /I 1 i
Date R
eq A.M. ** P.M. MST:
Location: 1/91,c &LQ,til .l t T ` ) BUP: � p �
• Tenant: Suite: Bldg: MEC:' d" ( ?,
Contractor: s i,,(LP � f • 9L/L4'72_-Phone: r Li - -?ew PLM:
Owner: Phone: ELC:
ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rou: -In Ceiling Water Line
Slab Framing Top Out 4EZW11' Rough -In UG Sprinkler
Foundation Insulation Sewer ' ood/Duct Reconnect Vault
Bsmt Damp Drywall Storm e_'_► Temp Service MISC.
Masonry Ceiling Rain Drain I UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved o Appro _ _ Not Approved Not Approved
FINAL FINAL FINAL FINAL
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all for reinspectio O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: < Date: -- �� Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 3/`9 l A.M. A � _ P.M. MST:
Location: J_ _ 4 / /� / i / /_' /,1 BUP:
Tenant: Suite: Bldg: MEC: C F . 0092
Contractor: Ai_ \ , ___, ♦ I I /. __' Phone: 6 ((-- I' PLM:
Owner: / Phone: ELC:
�� > �� — 2 ELR:
SIT:
BUILDING BLDG (con't) PLUMBING 61LCHANICAL O ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rou: -In Ceiling Water Line
Slab Framing Top Out 4dirgrd7P + Rough -In UG Sprinkler
Foundation Insulation Sewer • ood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved AI'roved Approved
Appr /Sdwlk Not Approved Not Approved ed of Approv =. Not Approved
FINAL FINAL FINAL I ' 1 FINAL
vi.0 (-Vac-Tr/ cck/ l�'orn i r ry n S/ iC Poc pi ed ) e t rct l
7 A cAt 1 et, C�,
3t95 c__?.e1 -
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
Inspector: Date: S ^ ( �f % ye Page of