Permit A CITY OF T MECHANICAL
4,41 1 \Ak ` DEVELOPMENT SER VIC ES PERMIT # • MEC98 -0114
''� �-. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 04/01/98
PARCEL: 1S133AD -12700
SITE ADDRESS...: 12621 SW SPRINGWOOD DR
SUBDIVISION • SUMMER LAKE ZONING: R -7
BLOCK • LOT •008 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 • 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 < 100K BTU: 0 (= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Install A/C unit
Owner: FEES
MORRISON type amount by date recpt
12621 SW SPRINGWOOD DR PRMT $ 25.00 JSD 04/01/98 98- 304587
TIGARD OR 97223 SPCT $ 1.25 JSD 04/01/98 98- 304587
Phone #:
Contract or:
PORTLAND METRO —AIRE
10010 SW BEAVERTON HILLSDALE HWY
26.25 TOTAL
BEAVERTON OR 97005
Phone #: 626 -7818
Reg #..: 000612
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Cooling Unt Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 - 001080. You may
obtain copies of these rules or direct questions to O1JNC by calling
(503)246 -9187.
4 0 1111 :4: -
Issue By: — 0 Permittee Signature:
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Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
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Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd -
TIGARD,. OIL 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type
Permit # f C W-0 / /c.7
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address i2.-621 Sto tenn Q Dr
Bldg# , r dity/State / zi ^�� � 1.) Furnace to 100,000 BTU 6.00
7 qal I including ducts & vents
Name (or name of business) / 2.) Furnace 100,000 BTU+ 7.50
Owner Al (3y - y ) S o Yki including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
including vent
City/State Zip 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. I 6.00 / 0
to 3 HP; absorb unit to 100K BUT" J b
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
PMA 15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy 30 -50 HP; absorb unit 1- 1.75mil BTU"
of all licenses City/State () zi ps P hone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if �b / O S,�) ((} /4/ 62� -7g1 > 50 HP; absorb unit 1.75 mil BTU"
expired in COT Ore y g onst. Cont. Board Lic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database {,/ 'Z' J 7 70' f- �S'
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 pr Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential, Non- residential 0
Additional Description of work: 17.) Domestic incinerators 7.50
•
18.) Commercial or industrial type 30.00
Incinerator
Existing 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 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 *SUBTOTAL - �C
`r 1-4�W/ I L . "' /--' 5% SURCHARGE 7
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL r '
g A if v ocrrxeit Z Z -39'4 TOTAL _ C N t
i:Unechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit.
O G J
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40
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CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
ei/16 BUP
r(
` 0 Date Requested ' 2 A �PM BLD
Location l ZED ? 1 S(4J eStaMil Sui" to MEC
C f? - 0/
Contact Person h0)\_ /
0)\_ Ph 5Y0 5 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC C / F — Q , 97
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: WILW
Slab
SIT
Post & Beam Plata �-�L �Q_,_ Oy_ /'� �� Q / O
Ext Sheath /Shear pU L `i J1 �/
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
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
PASS PAkT FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
S • - - Dampers
Wit•.
`�'��" ' • 'T FAIL �,,// ,� n - ,� i✓ 5-ex ��f'1..(` "`-"
CTRICAL t ocrt «,nd A
Service
Rough
UG /Slab In
Low Voltage P (C)
Fi larm
ina
S 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
Other Date � — Z Z � Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.