Permit - :CITY.OF• TIGARD� ,
i , • .
MECHA NICAL
' #,1 i DEVELOPMENT SERVICES PERMIT
• �� PERMIT #:.... a .. : .MEC 9- -0046
,d- = 13125'SW'Hall Blvd., Tig OR 97223 (503) 639 -4171 DATE ISSUED; 0 i -/ i 9
- PARCEL : ES 1 15130- 0812101221 ' '
SITE ADDRESS...: 16735 SW QUEEN ANNE AVE
SUBDIVISION....: ZONING:
BLOCK .....: LOT........ .... - 'JURISDICTION: KIN . ,
CLASS OF WORK. e :ALT . FLOOR FUI N ^ 0+ - EVAP COOLERS: 0 .
TYPE OF USER ...:SF UNIT HEATERS..: 0+ VENT FANS...: • ►Z+ ' '
OCCUPANCY G_RP. e : R3' .VENTS W/0 App'L: 0 VENT SYSTEMS: 0
STORIES........: 0 BOILERS /COMPRESSORS HOODS..n....e 0:- '
FUEL TYPES-- - - - - -- ------ - • • Q+ HP....: +ZI DOMES. I NC I N : '2) ' '
„ • 3 -15 HP.....: 0 COMML., I NC I.N : 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_. ',A I R HANDLING UNITS' , 'OTHE R UNITS.: +Z+ -
F-URN < 10+0K BTU: 21 <= t0000 c f m : 0. .GAS OUTLETS.: 1
FURI'I' -) =100K BTU: 0 1 10000 c. f m : 0
•
Remarks: Add gas piping.
flwn r _ - - - -• -- --- FEE S - --.__. . - --
RON DAVIS r type amount ' bY' date . recpit
16735 SSW 'QUEEN ANNE PRMT $ . 25.00''GEO 01/29/99 RING CITY'
KING CITY OR 97E24 5PCT $ 1.-.25 GEO 121,1/``3/99 KING CITY
Phone #: 603- -9G44, - •
Contract or: -- -- ---------- - - - - -- •
, .
AIREFLO, HEATING & AIR CONDITI . .
PO BOX 328,
' 26.25 TOTAL -
I-f I LLSBO,RD O R 97123 .
Phone #k': 64073607 . .
Reg #.. 2 , 0005212' ,
-- REQUIRED INSPECTIONS ----;.---=-
This, permit is, issued subject'.to the regulations contained in 'the Final Inspect ion - - _ - „
Tigard Municipal Code, State.of Ore, Specialty Codes and all other _ __ __ _
'applicable 'laWs, ..All work will lie 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 mote ��� ' •
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- '�'�10'through OAR 952- 001 -0080: You nay - _
obtain copies 'of these rules'�or direct questions to OUNC by calling ' ' ____ _�_ _— -----_,__--__
(503 1246 -9187.
, ./ / 4 e t . H ,
Issue - By: 41, ,, - Permittee Signature: - - - A_____
4-++++++++++- F.+++++++++++++++- I-+++++++++++++++ + + + +-1- + + ++ + + + + + + + + +-1- + ++ + + + ++ +-1--1--1-+ + + +4 -„ '
,Call 639-4175 by 7:00 p.m." for inspections needed the next b6siness day ,
'+•+ h+ 1-+++ ++ + + + + + + + + + + + + + +++++ ++ + +-I- + + +• - 17 +- I- + ++'-F ++° F•+ + ++ + + + ++ + + ++ + + + +-I-• +•-F• ± ±+ + ++ f + + + +-r•
'JAN- 28 -'99 THU 15:45 ID: FAX N0: 14085 P02 _ o
CITY OF TIGARD Plan Check #
Mechanical Permit Application Reed By AA
13125 3W HALL BLVD. Commercial and Residential Date Recd I- LX -11
TIGARD, OR 97223 Date to P,E.
(503) 639 -4171, x304 Date to DST - Z Z - I i
Print or Type Permit # ...e
Incomplete or illegible applications will not be accepted ca'18a
Name of Devetepnmant/Proiect Description
Table IA Mechanical Code Q1Y PRICE AMT
Job Street Address Wave A) Permit Fee
Address ' J�� Q K A .a. -0- 10.00
' e Ilzi 1.) Furnace to 100,000 BTU 6.00
including ducts & vents
Name (or nacre or DYatnesa) 2.) Furnace 100.000 BTU+
7,50
Owner 20f1. OCUI ( - S including ducts & vents
Mailing Address 3.) Floor Furnace
l i5 Q l 1 Q,QA - 1 9 s.00
including vent
ilig 4.) Suspended heater, wall heater
zip l 8,00
I I-- -� I or floor mounted hearer
Name ( erne or Inass) 5.) Vent not Included in appliance permit 3.00
Occupant anauk,9 Addraerl
P 6.) Boiler or comp, heat pump, air cord. 6.00
to 3 HP; absorb unit to 100K BUT' -
cky /State Zip , Phone 7.) Boiler or comp, heat pump, air cond. 11.00
I 3-t5 HP; absorb unit to 600K BTU"
Contractor Na"'e 8.) . Boiler or comp. heat pump, ai cond.
rW4 Fl
•o Merl � n 4A1� C nc 1 HP; absorb unil5.1 mil BTU""
15.00
l
Prior to permit Admeas 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, e a copy ,QD I ^ e..1 ye" 30-50 HP; absorb unit 1- 1.75mi1 STU°
of all licenses CIIy /Stare Lp Phone 10.) Boller or comp, heat pump, air cond. 37.50
are required if }��'S r ,De � as k. 3(oO7 > 50 HP; absorb unit 1.75 mU BTU•
expired in COT Oregon
Z��Co Board uc.ri Exp. pale 11.) Air handling unit to 10.000 CFM - 4,50
database 11-1q9
Architect Name 12.) Air handling unit 7.50
10,000 CTiM+
Or M9lling Address ^ 13.) Non•poitable evaporate cooler 4
Engineer City/Sudo Ilp Phase 14) Vent fan connected to a single duct V 3.00 •
Describe wort New 0 Addition 0 Alteration 0 Repair 0 15) Ventilation system not included 4,50
to be done Realdential 0 Non - residential 0 in appliance permit
V
Additional Description of work: 18.) Hood served by mechanical exhaust
4.50
17.) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial 30.00
building or property type Incinerator
19.) Repair units 4.50
Proposed use of
building or property 20.) Wood stove b SO
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 2
given is correct. that I am the Owner or authorized agent of I 2 • CD
the owner, that plans submitted are in compliance with Oregon State laws. Z4.) More than 4 outlet (each) .S0
Signature of Owner/Agent Dante
"SUBTOTAL ti
,/� ., c , r{. 2 - Ix
aqi 1140/4161 596 SURCHARGE
Co ct Person a me Phone PLAN REVIEW 25% OF SUBTOTAL i - -',.-7. .� • • '- .7 • (0D
r , Required for all commercial permits o �- - --
1L I1
Q ■, TOTAL K
'Min imum permit fee is $25 + 5% surc harge ' 't; 1Z' fell
:
mac- - C o f�Cf,�"1'�'ly l ._ .
"'Residential NC requires site plan showing placement of unit,
1:lmechpnnt,doc rev 4115/98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639-4175 Business Line: 639 -4171
BUP
) /A9 iLD Date Requested �/ /99 AM PM BLD
Location /& 7�J % /, � /�CQ�ii�r. G��j„� Suite MEC 5
Contact Person Ph PLM
Contractor _ _ _ , Ph &S/46 SWR
i
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation Q G& �/Ip v , h� FPS
Ftg Drain _ I _ SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear . % 3 ti/ 7
Framing q 1
Insulation �( /
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: _
Final
PART FAIL
LUMBING�
Post & Beam Under Slab /7/
Top Out
Water Service
Sanitary Sewer f 1
• -'1 Drains I -. A AL 7/� _ L / /
PAS • ' _ RT FAIL = /iiL�� risk f
� E aHANIC
Po st & Beam
ou•
Gas Lm �/ A� Ap _ �r�_.� �� —
Smoke Dampers / /
P
ASS PART FAIL
ELECTRICAL A ! ■ : /i.: /� -V
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 Date Z/) Inspector AAA-- Ext � y
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.