Permit A : CITY OF TIGARD MECHANICAL
, DEVELOPMENT SERVICES PERMIT
�� �i PERMIT # MEC96 -0433
°:_.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/12/96
PARCEL: 25111CA -02500
SITE ADDRESS. -•: 15433 SW SUMMERFIELD LN
SUBDIVISION : SUMMERFIELD NO.7 ZONING: R -7
BLOCK • LOT •328
CLASS OF WORK.•:ALT FLOOR FURN ° 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS -.: 0 VENT FANS...: 0
OCCUPANCY GRP..:A1 VENTS W/0 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 : 1 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.: 2
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks: instl furnace vents,pumb —a /c, & gas piping outlets
Owner: -- FEES
VIRGIL BROWN type amount by date recpt
15433 SW SUMMERFIELD LN PRMT $ 40.50 TAT 12/12/96 96- 287670
5PCT $ 2.02 TAT 12/12/96 96- 287670
TIGARD OR 97224
Phone #:
Contractor:
COLUMBIA HEATING
PO BOX 230397
TIGARD OR 97281
Phone #: 624 -2704 $ 42.52 TOTAL
Reg #. ° : 76359
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 Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signor ur : r , ,,t?,fik
Issued By: .
mill for inspection — 639 -4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
131,25 SW Hall Blvd. APPLICATION Permit #MEc96 - 0'7/33
Tigard, OR 97223
(503) 639 -4171
Name w °i Description
,jr ' T b D ,A)T1 Table 3A Mechanical Code QTY PRICE AMT
Job 5 - o , ' • IIll _ 1) Permit Fee 0 -0- 10.00
Address
2) Supplemental Permit 3.00
f (/)� /� � �� � Furn to 100,000 B i U
. q I 8.),/, 42L A /gqq 1) inc.'. ducts & vents / 6.00 6.00
Phone Furnace 100,000 BTU +
Owner .- 3 ,�10 J?)fl t h/ ELFt 2) ind. ducts & vents 7.50
ar 3 R 9 7,20241 3) Floor Fumance
3 ind. ven 6.00
e ra ° i Suspended heater, wall heater
4) or floor mounted heater 6.00
Maim' '� Ytone Vent not incl. in
Occupant 5) appliance permit 3.00
Ws DP Repair of heating, refng.
6) cooling, absorption unit 6.00
/" Boiler or comp, heat pump, air cond.
I,t 1`t Mt" 7) to 3 HP; absorp unit to 100K BTU 6.00
� " w ' hone Boiler or comp, heat pump, air cond.
Contractor ' u,�, / L} i/' 7 vU 620---?7 8) 3 -15 HP; absorp unit to 500K BTU 11.00
°47 - ! 74.2 � Boiler or comp, heat pump, air cond.
9) 15 -30 HP; absorp unit .5 -1 mil BTU 15.00
ry �" T ° " Boiler or comp, heat pump, air cond.
fqata
7 369 g5 , 340 f 10) 30-50 HP; absorp unit 1 -1.75 mil BTU I 22.50 2.?. 50
I hereby acknowledge a r have read this application, that the Boiler or comp, heat pump, air cond.
information given is correct, that I am the owner or authorized agent 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
of the owner, that plans submitted are in compliance with State Air handling unit to
laws, that I am registered with the Construction Contractors Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air handling unit
please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent tan connected
15) to a single duct 3.00
/ ' Ventilation system not
' jJ �! 4 /�Gfi� yt�! a— 9 -9k 16 included in appliance permit 4.50
r (( t ^mil �ttii"" ,)` Hood served by
17) mechanical exhaust 4.50
Describe work new U addition U alteration t;) repair U Commercial or industrial
to be done residential 0 non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00 p?_
building or property
Type of fuel - oil natural gas LPG 21) More than 4 -per outlet
T
YP 0 9 0 0 electric O
NOTICE
Minimum Fee $25.00 SUBTOTAL Z ia 50
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE a?, l
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL 1 1.2.5,
Special Conditions
Date issued by
IwMECHPMT
woadb°md.v
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: AM: P.M. MST:
Location: - 44 //L / /_: / . i , •06 __ BUP:
Tenant: / Suite: Bldg: MEC: / y 6 - )) 0
Contractor: _...% . 41/1 � 4 y . � ' Phone: 4f 2 7 0 44 PLM: a G 3 7
Owner:
Phone: ELC:
el f vx..4_, __ `"e. c_efiz. d ) ) 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 Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer J, Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm �T C A7C— Temp Service MISC.
Masonry Ceiling Rain Drain UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved CApprov Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL 461141-711° FINAL FINAL
c,,g / , _ / A.._ _at/ 4 /.
. JA .' _A. .. 1 :
-�.., if _' G. . _
r
I /
O Call for reinspection 0 Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: Date: C/ Page k- of r-