Permit C ITY OF TIGARD MECHANICAL PERMIT
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DEVELOPMENT SERVICES PERMIT #: MEC1999 -00427
r, I I 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/12/1999
PARCEL: 1 S 135CC -03600
SITE ADDRESS: 10140 SW TIGARD ST
SUBDIVISION: GREENBURG HEIGHTS ADDITION ZONING: R -4.5
BLOCK: LOT: 010 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: 1
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of freestanding gas stove and gas line to stove. ..
Owner: FEES
EDNA WEBB Type By Date Amount Receipt
10140 SW TIGARD ST 5PCT GEO 10/12/19c $4.00 99- 318995
TIGARD, OR 97223 PRMT GEO 10/12/19. $50.00 99- 318995
Total $54.00
Phone: 503 - 639 -2823
Contractor:
SCOTT A. SHAM BURG HEATING LLC
380 SUNSET CT
SHERWOOD, OR "97140 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 625 -3828 Woodstove lnsp
Reg #: LIC 126881 Final Inspection
ORIGINAL
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 in 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)246r•189.
/
Issue By: „`� /� Permittee Signature:A' � , L / /ii /_`./
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
„1312v SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 °si-- Date to DST
w
Print or Type Permit Otte Mil - oo
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
S treet Address Suite# A) Permit Fee r� 16.00
Job ,,/ �+L 1) Furnace to 100,000 BTU
Address /01 � U $' including ducts & vents see footnote 1,2 9.65
Bldg# /State Zip 2) Furnace 100,000 BTU+
- 719Q/d b'2 97.;? including ducts & vents see footnote 1,2 12.00
Name (or name of business);/ 3) Floor Furnace
Owner `Gt
�+ - GC ,, .r�., ), v 6 including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
/O /'/O .5,J T /O 5) Vent floor mounted see footnote 1,2 9.65
Vent not included in appliance in appliance permit 4.75
City /State Zip Phone Check all that apply: 'Boiler Heat Air
lip. d d� 9 �, 3 631-A,13 For items 6 -10, see or Pump Cond Qty Price Amt
N name of business) footnotes 1,2 Comp
L 6) <3HP;absorb unit to
5,.vni a.S &pr. / 100K BTU 9.65
Occupant Mailing Address 7) 3 -15 HP;absorb unit
100k to 500k BTU '"' 17.65
City/State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Contractor Name 9) 30 -50 HP; absorb
L / unit 1 -1.75 mil BTU 36.00
/7g/jjhily ac 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy 3f0n rt 11 Air handling unit to 10,000 CFM
of all licenses Crty /State Zip - Phone 7.00
are required if /kJOGa £ 9 1x`/0 625" :3rd 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont Board Lic.# Exp. Date 11.85
database /alegf/ 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct
M ailing Address 4.75
Or 15) Ventilation system not included in
appliance permit 7.00
Engineer City /State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
12.00
New 0 Repair 0 Replace with like kind. Yes 0 No 0 18) Commercial or industrial type incinerator
Residential & Commercial 0 48.25
19) Repair units
Additional information or description of work' 8.40
/gstia21- silo/) o e/L/S Q� /l79 ya s sfnve 4 jzs Ifni.'
[2c 20) Wood stove /gas FP /other units /clothe dryer /etc.
s tavt / 7.00 7.1
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 / 3.75 ..,• 7
Type of fuel: oil 0 natural gas eK ✓ LPG 0 electnc O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE OM MINN€ ..I.
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL ' -;, .• •
Required for ALL commercial permits only ' -; :: ,°..:.
the owner, that plans submitted are in compliance with Oregon State laws. //
TOTAL ; . ''' 77
Signature of Owner /Agent Date
��Q Other Inspections and Fees:
h7�� � /a /a 1 . Inspections outside of normal business hours (mininum charge -two
Contact Person Name Phone hours) $50.00 per hour -
L . • A 2. Inspections for which no fee is specifically indicated (minimum
L,54) Lga/n€ J b 5 3��8 charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1 Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge -one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. "State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I:\rnechperm.doc rev 7/19/99
1/25/00 Activities for Case #: MEC1999 -00427
3:32:38 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 10/12/99 GEO RECD No Hold GEO 10/12/99
MECA008 Create Permit 10/12/99 GEO DONE No Hold GEO 10/12/99
MECA705 Gas Line Insp No Hold GEO 10/12/99
MECA720 Woodstove Insp No Hold GEO 10/12/99
MECA799 Final Inspection 10/13/99 RB PASS No Hold ST 10/14/99 1. Seal gas line through shield
' .2. Protect gas line at exterior -
paint w /metal type paint
MECA060 (F) Issue permit 10/12/99 GEO DONE No Hold GEO 10/12/99
MECA800 Case Finaled 1/19/00 AKJ DONE No Hold AKJ 1/19/00
•
Page 1 of 1
CITY OF TIGARD BUILDING INSPECTION DIVISION sT 1.799 -cni
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
Date Requested / AM x PM BLD
Location (01 LI Ti Suite n (qQ 9 � CYO x(27
Contact Person (il'GZ Ph COY? 'Z / L/ / �y PLM
Contractor Ph SWR
UILDIN� Tenant/Owner ELC
Retaining Wall ELR
Footing Ac cess:
Foundatio FPS
—
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab - ' -�-C�t � rfO �/ SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing �V v � ��f 7n1 z.-X �ZN c,< v \ '(1
Insulation
Drywall � 7 (/d 1 �.�/�-
Drywall Nailing s • '�`�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: ue►
=v PART FAIL
I Br OP
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
AM. PART FAIL
HAN • L
Post & Beam V �' ∎V
Rough In , +�j7 oq� } I
Gas Line ( )
Smoke Damp- %,
!a^ PART FAIL
ELECTRICAL
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 Q��'1js`� 1 / Dat � � � 0 Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.