Permit CITY OF TIGARD
, DEVELOPMENT SERVICES PERMIT #: MEC2000 -00109
'II MECHAN PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 03/31/2000
PARCEL: 2S1 15AA -08300
SITE ADDRESS: 10587 SW TITAN LN
SUBDIVISION: BERKLEY ESTATES ZONING: R -4.5
BLOCK: LOT: 015 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of gas fireplace insert and gas line.
Owner: FEES
ZABACK, ROBERT A+ TONI Type By Date Amount Receipt
10587 SW TITAN LN PRMT GEO 03/31/20( $50.00 0001084
TIGARD, OR 97224 5PCT GEO 03/31/20C $4.00 0001084
• Total $54.00
Phone:
Contractor:
ANCHOR FIREPLACE PRODUCTS INC
14175 SW GALBREATH DR
SHERWOOD, OR 97140 -9170 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 925 -8888 Woodstove Insp
Reg #: LIC 102814 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)246 -91 ;9.
Issue By: & Signature:
IA Permittee Si
Y 4�/� 9
Call ( 1 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day
08/20/99 FRI 16:55 FAX 503 598 1960 CITY OF TIGARD �_ �� I j 002
�, .. I (� Plan Check #
CITY OF TIGARD Mechanical Permit Application 1 i / 'V Redd By
13125 SW HALL BLVD. Commercial and Residential RECEIVED Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 MAR 31 2000 Date to DST
•
Print or Type Permit #,If-e - a 0 /aq
Incomplete or illegible. applications willetqVitraf�1T Called
Name or oevelopment/ProJed • Description
f Table 1A Mechanical Code Q Price Amt
P.irT a A) Permit Fee ';ilr `- .,, , ,” : , ... :. ,'• 16.00
Job j0d�f°'a / s" 1) Fumace to 100,000 BTU
Address 1R� S 1/3_T-Cfty fState I f� N 1 induding duds & vents see footnote 1,2 9.65
vP 2) Furnace 100,000 BTU+
Ti rrd 9 �a -t including ducts & vents see footnote 1,2 12.00
Name (or name of business) �,, �- 3) Floor Furnace
Owner �e1(�Q, az a-6 Gt'- including vent see footnote 1,2 9.65 ,
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater see footnote 1,2 9.65
5) Vent not included In appliance permit ( , 4.75 t-(.
City/State ZIP o
I Phone Check all that apply: *Boller Heat Air
For items 6-10, see or Pump Cond Qty Price Amt
•
Name (or name of business) footnotes 1,2 Comp
O J n �r L, 6) 4HP;absorb unit to
(�,( 100K BTU 9
Occupant Mailing Address 7) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
City/State Zip l Phone 8) 15 - HP; absorb
unit .5-1 mil BTU 24.15
9) 30-50 HP; absorb
Contractor . r8R1B , � t, t� unit 1 10) >5 0HP mil BTU 36.00
�••1� 0HP; absorb unit
Prior to permit �Ii Address � >1.75 mil BTU 60.15
issuance, a copy I LA t < \ S( j41A Ib
) �Uecdl/\ iU ^ 11 Air handling unit to 10,000 CFM
of all licenses pltylSfate Zip Phone 7.00
are required if < AO T (1 (. Oi✓ q1140 Gam 8868 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Leal Exp. Date 11
database (,D � 'l (� I2 (o ( 01 13) Non - portable evaporate cooler
Architect Name 7.00 .
14) Vent fan connected to a single duct
4.75
Or Mailing Address 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 Ike kind: Yes O No O 18) Commercial or industrial type incinerator
Residential Commercial0 48.25
19) Repair units
Additional information or description of work: 1 8.40
20) Wood stove gas F other units/clothe dryer/etc.
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calks. See footnote 1 1 3.75 •
Type of fuel: oil 0 natural gas LPG 0 electric O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL T J'_r l: ;y: •. , •
I hereby acknowledge that I have read this application, that the Information • ' - - TE.: 1111 : . o o
y
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL R r� _
Required the owner, that plans submitted are in compliance with Oregon State laws. • R commercial permits on F
� for ALL commerc � � , r 1�i k 1""' .
TOTAL e=�r
Signature of OwnerfAgent Date ,,,-;,,,.;.,:59 . . };,,,° ■ , U t
Other Inspections and Fees:
1. Inspections outside of normal business hours (minlnum charge -two •
Contact Person Name Phone hours) $50.00 per hour
loly)t.uf-- 2. Inspections for which no fee Is specifically Indicated (minimum
Sb 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 NC requires site plan showing placement of unit
I:\mechpern.doc rev 02/4/99
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
u �( BUP
Date Requested 1 deo AM <` PM BLD
Location 1 O S n Suite : 21100 'CO 107
Contact Person St A 24- e- Ph q iS R g gO PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear t r i X cc� (,( ✓� Q�
Int Sheath /Shear
Framing
Insulation
Drywall Nailing 0 —5 — lee - A S TU @
Firewall
Fire Sprinkler ,AP • s— —= l • - . S, o /t,
Fire Alarm
Susp'd Ceiling C -?ge 7F
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
M 1FIAN1
Post : ' - .
- • gh In
-s is-
Sm•ke Dampers
PART FAIL
ELECTRICAL /
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ I 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 y - 2 Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.