Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2000 -00294
•��� DATE ISSUED: 7/24/00
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S125DD -03800
SITE ADDRESS: 09865 SW VENTURA CT
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 ZONING: R -4.5
BLOCK: LOT: 046 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:
LPG 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:
GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas fireplace insert and gas piping.
Owner: FEES
KOSTUR, CHARLES J + DIANNE M Type By Date Amount Receipt
9865 SW VENTURA CT PRMT BLD 7/24/00 $50.00 0003899
TIGARD, OR 97223 5PCT BLD 7/24/00 $4.00 0003899
Total $54.00
Phone:
Contractor:
GP + W SYSTEMS, INC
732 MARBLE RD
WASHOUGAL, WA 98671 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 360 - 835 -3516 Woodstove Insp
Reg #: LIC 108176
•
•
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 c. ins .0 - 246 -9189.
Issue By: Permittee Signature: Ati� ,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
'l/
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CITY-�)F TIGARD Mechanical Permit Application Plan Check#
'As, p p Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit# fri6rsoa - ao�y
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address nutte# A) Permit Fees. 16.00
Address q � V ..1-. r4 C;i _ 1) Furnace to 100,000 BTU
Bldg# crty/state Zip including ducts & vents see footnote 1,2 9.65
2) Furnace 100,000 BTU+
Their, or 9 J0 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner teo 5
A-R.crs including vent see footnote 1,2 9.65
Mailing Address 1 4) Suspended heater, wall heater
m or floor mounted heater see footnote 1,2 9.65
5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: 'Boiler Heat Air
For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
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
a Pi_w 3 yviS unit 1 -1.75 mil BTU 36.00
10) >50HP; absorb unit
Prior to permit Mailing Address ' q/ >1.75 mil BTU 60.15
issuance, a copy -) 32 /nor b/e i d 11 Air handling unit to 10,000 CFM
of all licenses Crty /State Zip Phone 7.00
are required if WA Sir 1 14 -i* 9' i7) 36043 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board LIc.# Exp. Date 17-- 11.75
1 • database /c? X /7 ( 06 -0 / 13) Non - portable evaporate cooler .
Architect Name 7.00
14) Vent fan connected to a single duct
or Mailing Address 4.75
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 VC Commercial 0 48.25
19) Repair units
Additional information or description of work: 8.40
/ Q T rh d•,e p l r re 4' - 20) Wood stove /gas FP /other units /clothe dryer /etc. /
9 l4 fu ci psImits r v rae e- 7.00 2.00
NOTE: For Commercial projects only; Un over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 ( 3.75 3.)5"
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 ?� . " So .0-0
I hereby acknowledge that I have read this application, that the information gO7p�7- WS`URCHARGE 4'. e n)
given is correc that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL r •
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only, <{
TOTAL , ) ,
Signa •f Own - rl • • ent Date ���'
.." - _ , )( ) i OD Other Inspections and Fees:
1. - Inspections outside of normal business hours (mininum charge -two
Con - Perso • . Phone hours) $50.00 per hour
Lew1 1 t n l )c ,3(o0-£f3J- 35/6 2. Inspections for which no fee is specifically indicated (minimum
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: mechperm.doc rev 02/4/99
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ST
BUP
Date Requested 1 7-2 (0 AM PM BLD
Location f r �� SL✓ ✓#v / urn Suite MEC Awry -Q°; 9L(
Contact Person Ph v'Zly Z y 9 PLM
Contractor Ph 0 - ‘30 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
Int Sheath /Shear
Framing „7/ C/ite � c'� O /6s1-z__. -
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 .
PASS PART FAIL
EC HANIC
Post & Beam
Rough In
Gas Line
Smoke Dampers
ina
AS PART FAIL
E _E - CTRICAL
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
Other D — 2 ' — d Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 . , Business Line: 639 -4171
r (J , / BUP
Date Requested 7 -1 ) i • A M'� PM B 4%
Location 5 s vPyt fy Ct• Suite Z Go//- G UA9 V
Contact Person Ph ,;-93 G a- 9 PLM
Contractor Kam- Ph 77z- - 3z5 , SWR •
BUILDING Tenant/Owner ELC
. Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: _ 1 SGN
Slab �] �G (� , "tip ��1� SIT
Post & Beam / •
Ext Sheath /Shear Gj O I e �M_
Ina Sheath /Shear Q ` g 69S
Framing >
Insulation TQ S 3gcf G9 /0 /0I J 2
Drywall Nailing 1 b
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
PASS PART FAIL
ECHANICA
•
Post & Beam U
Rough In mil
\ i/.6.
.
as Line U
o e Dampers
Final
PART FAIL
RICAL
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 b�
Other Date Inspector Ex
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.