Permit CITY OF T MECHANICAL
,. A , ,9, 0 DEVELOPMENT SERVICES PERMIT
_
}__. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # - MEC97 - -0409 DATE ISSUED: 10/20/97
PARCEL: 1S133CC- 01E300
SITE ADDRESS...: 11667 SW TALLWOOD DR
SUBDIVISION....: PEBBLECREEK ZONING: R -25
BLOCK............ LOT... ...... ....:012 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.: 1
FURN < 100K BTU: 0 (= 10000 cfm: 0 GAS OUTLETS.: 1
FURN >=100K BTU: 0 > 10000 cfm: 0
Remarks: Install gas piping and gas insert in an existing fireplace.
Owner: -------- FEES -----
COLLEEN POST type amount by date recpt
11667 SW TALLWOOD DRIVE PRMT $ 25.00 GEO 10/20/97 97- 300185
TIGARD OR 97223 SPCT $ 1.25 GEO 10/20/97 97- 300185
Phone #: 579 -2400
Contract or: --
T & K MECHANICAL
TIMOTHY S WYNNE - - - - -- --
15555 SW 76TH AVE $ 26.25 TOTAL
BEAVERTON OR 97005
Phone #: 626 -4652
Reg #..: 001211
-- 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 W o o d s t o v e Insp
approved plans. This permit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for more Final Inspection
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: if' r %� _ Permittee Signature: �.__
+ + ++ ++ +++ +++ + +++-I + + +++ ++-I- + ++ + + +- -I-+ ++ ++ ++ + +- +++++++++ -I- + + ++ ++ + ++ ++-I-++++ + + ++ + +++ ++
Call 639-4175 by 7 :00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++++ ++ + + + + + ++ + + + + + +-I- ++ + + + + ++ + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application ,, Rec'd By
13125 S/ HALL BLVD. Commercial and Residential ' ,�) Date Rec'd
TIGARD, OR 97223 v Date to P.E.
(503) 639 -4171, x304 2 � � Date to DST
Permit # OS/O7
Print or Type .
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address _ J Suite# - A) Permit Fee -0- -0- 10.00
Address //'(d7 S.J Ta /(Ciivc4 ar
Bldg# - City/State Zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner PO - e [ _ Q;,,■___ including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
I //,olcr7 3t.-) / � / /c,t)c yC1 Dr- including vent
SA/State Zip Phone 4.) Suspended heater, wall heater 6.00
I i aa ✓t7 77a1.j 577-.7 gez or floor mounted heater •
Namettpr name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Ad ress 6.) Boiler or comp, heat pump, air cond. 6.00
146 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
(Prior to 7-t Kc.?. i Ced 15-30 HP; absorb unit.5 -1 mil BTU"
issuance Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
applicant f iS, 6' e0114Lc. )v 30-50 HP; absorb unit 1- 1.75mil BTU"
must provide all /State Q 4 Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor ) P / OV\ [ �7C (r,,;26; geri 11 > 50 HP; absorb unit 1.75 mil BTU"
license Oregon Const Cont. Board Lic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50 •
information 60 Ii(. 3-07 48'
for COT COT Bu Tax or Metro # Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database). (U
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 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential O
Additional Description of work 17.) Domestic incinerators 7.50
0a5 tyksev- `L ext 4Qtvt�l c''
U 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 n
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50 p(
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, en i • nt Date *SUBTOTAL
C O /;„ 0 i /7 /f 5% SURCHARGE , ia_
Con t ' l ers / on Na a Ph PLAN REVIEW 25% OF SUBTOTAL
6 ;2/ P Z , TOTAL i lD�
i :ldst\mechpmt.doc (rev 9 C V6" S "7 Mi - Minimum permit fee is $25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit.
RECEIVED
OCT 2 0 1997
COMMUNITY DEVELOPN,I,4'
CITY OF TIGARD BUILDING INSPECTION 1 "
24 -Hour Inspection Line: 639 -4175 Business ' one: 639 -4171 9•4;-2_ .
Date Requested: /1 / 74 7 /J A.M. P.M. MST:
Location: / I ( (0 7 5',L�() � ((:( T X BUP: p�
1 (�` l
Tenant: Suite: Bldg: MEC: 7 7 6 / 0 /
Contractor: S -, FP Phone: (I/ ..)-6, - �((j ;5 -- J PLM:
Owner: Lt Phone: ie.-Ca. i` ELC:
`J 7? - '- o 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 Rough -In Ceiling Water Line
Slab Framing Top Out as Line Rough -In UG Sprinkler
Foundation Insulation Sewer o u _ R econnect Vault
Bsmt Damp Drywall Storm rF aso- { 4-e• A ) emp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved Approved a :. Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved ' Not Approved Not Approved
1 �!; ` �i / I�+�}y� FINAL Q-/1,' FINAL , ,, f� .f' •\ �/) /n FINAL FIN
/ /7
,.. _.&„ : -- .--ei-,-...1 (,_,..,,e_ ,..:. ,,,„...e...„,,,___
__,...35_.LT,,,,,,,. - tz._... ff e„..,,, -,4 e--• - rte- r�
'`''' ,
L.Q.-t ./l— 4.. f' /ecr-z- /-&-z, 0„4 .-,.
O Call for reinspects O R ' nspection fee of $ required before next inspection O Unable to inspect
Inspector: '
L'& Date: //^ / 7 ---- 9 7 Page of
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
�� BUP
0 i4-4 6 Date Requested /OP, 9 3' AM a PM BLD
Location / 1 (0 7 5(it) Suite q 7 -0q c 7
Contact Person Ph PLM
Contractor thu Ph (p �g' 443 SWR
BUILDING _ Tenant/Owner Cott ijt Paz ELC
Retaining Wall ELR
Footing Access:
Foundation I1A.1 SON (4-11,ta f6 t 30 FPS
Ftg Drain SGN �'
Crawl Drain Inspection Notes: Air
Slab SIT
Post & Beam
Ext Sheath /Shear
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
P�9SS —RAC FAIL
Post & Beam
Rough In
Gas Line
Siuoke Damper
r'na
PASS PART FAIL
EtETTRtCAL
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 ,` 9
Other Date / 0 <r — L Inspector L/ E x t
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.