Permit I
A \- CITY OF TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
: ll. 13125 SW Hall Blvd., Tigard, 0R 97223 (503) 639 -4171 DATE I ISSUED: 11/24 -0530
PARCEL: 1S125DD -09000
SITE ADDRESS...: 09678 SW VENTURA CT
SUBDIVISION • WASHINGTON SQUARE ESTATES NO.3 ZONING: R -4.5
BLOCK LOT •098 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.: 1
FURN ) =100K BTU: 1 ) 10000 cfm: 0
Remarks: Berglund
Owner: FEES
BERGLUND type amount by date recpt
9678 SW VENTURA CT PRMT $ 25.50 JSD 11 /24/98 98- 311054
TIGARD OR 97223 SPCT $ 1.28 JSD 11/24/98 98- 311054
Phone #:
Contractor:
ROBBEN & SONS HEATING
2300 SE 7TH AVE
P 0 BOX 14867 $ 26.78 TOTAL
PORTLAND OR 97214
Phone #: 233 -5841
Reg #.. 001884
REQU IRED INSPECTIONS
This permit is issued subject to the regulations contained in the Heating Unt Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Cooling Unt Insp
applicable laws. All work will be done in accordance with Final Inspection
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 - 001-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
ANOW21110
Issue By° Permittee Signature: / `/
+ + + + + + + + + + + ++ +++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY Of TIGARD Mechanical Permit Application Plan Check Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd %/ Z f —
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST Q
Print or Type Permit # A16 C %? pfd
Incomplete or illegible applications will not be accepted Called 0 --- e
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Jobfo0 Suite# A) Permit Fee 10.00
1) Furnace to 100,000 BTU
Address including ducts & vents 6.00
Bldg # - City /State Zip 2) Furnace 100,000 BTU+
including ducts & vents 1 7.50 175
Na (or name siness) 3) Floor Furnace
Owner including vent 6.00
Mailing Add s 4) Suspended heater, wall heater
9Z7c rIA � o r floor mounted heater 6.00
5) Vent not included in appliance permit
City /Sta e Zip Phone 3.00
�717i 2_,d CHECK ALL `Boiler Heat Air
Na (or name 6r bus THAT APPLY or Pump Cond Qty Price Amt
Comp
Occupant Mailing Addres 100K BTUbsorb unit to (9''
d 6.00
7) 3 -15 HP,absorb unit
City /State Zip I Phone 100k to 500k BTU 11 00
8) 15 -30 HP; absorb
Contractor {t / �� p unit 5 -1 mil BTU 15.00
I- ii 14 , 9' \ r�� u( 9) 30-50 HP; absorb
L unit 1 -1 75 mil BTU 22.50
Prior to permit .111.9 Addres 0 / 10) >50HP, absorb unit
issuance, a copy A ,, / i >1.75 and BTU 37.50
of all licenses C 4 /II��% E P�j ow 11) Air handling unit to 10,000 CFM 4.50
are required if j , , f : ���' pf
expired in COT •regon Cone Bo. • is #
Vey :J 917 12) Air handling unit 10,000 CFM+
database ��[ gyp(/ 7.50
Architect Name 13) Non - portable evaporate cooler
4.50
Or Mailing Address 14) Vent fan connected to a single duct
3.00
15) Ventilation system not included in
Engineer City /State Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New 0 Re air 0 Replace with like kind: Yes'No 0 7.50
Residentia Commercial O 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
4 50
20) Wood stove
4.50
21) Clothes dryer, etc.
4.50
Type of fuel oil 0 natural gas LPG 0 electric 0 22) Other units
4.50
I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets a p
given is correct, . I am the owner or authorized agent of / 2.00
the owner, th. plans ubmitted are in com.liance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Signatu : of Own- A . , , - Date
, / Minimum Permit Fee $25.00 SUBTOTAL �/
-i/ G 5% SURCHARGE tin= Con.:ct - erson Name Phone PLAN REVIEW 25% OF SUBTOTAL
f Required for ALL commercial permits only
37 ' �� / 7 TOTAL ��
*State Contractor Boiler Certification required
**Residential NC requires site plan showing placement of unit
I:\mechperm.doc rev 07/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
i��o9 / I2-17-96F BUP
�3 Date Requested AM PM BLD
Location • i � • k) _ fin/Mt At _ Suite /f 71253 n
Contact Person , Ph PLM
Contractor .. /1/ C_...L_ .e ` Ph 233-5841 SWR
g -0 7 1 ,4 1 BUILDING Tenant/Owner
Retaining Wall R
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing , itAe
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING �1
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
P SS P RT FAIL
IECHANICAI:
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
P ART FAIL
(ECTRICAN
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
• PART FAIL
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 / Ottheoach /Sidewalk Date / Z / 7/ Inspector �C Ext
Final
. PASS PART FAIL DO NOT EMOVE this inspection record from the job site.