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11855 SW KATHERINE 5T i
MECHANICt,: PERMIT
CITY OF TIGARD
DEVELOPMENT SERVICES /PERMIT,;: MEC20_�000033
-� 13125 SW Hall Blvd.,Ti-:rd, OR 97223 (503) 639-4171 ,\/PERMIT,:.
ISSUED: 1/26/00
^� PARCEL: 1S134CD-00600
SITE ADDRESS: 11855 SVV KHTHERINE ST C�
SUBDIVISION LERON HEIGHTS NO.3 � ZONING: R-4.5
BLOCK: LOT: 076 a JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VE.rT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRES.3ORS _ HOODS:
FUEL TYrCS 0 - 3 HP: DOMES. INCIN:
LNG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP:
REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP:
WOUDSTOVES:
GAS PRESSURE: 50 + IIP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNIT S_ _
FURN >=:100K BTU: <= 10000 cfm: M_ OTHER UNITS:
> GAS OUTLETS:
10000 cfm:
Rema ks: Replacement of existing furna;e with like kind.
Owner: r_——--- FEES
BLINTZ WILLIAM .1 Type By � Date Amount Receipt
11,855 KATHERINE ST PRMT DEB 1/26/00 $50.00 OL-321413
TIGARD, OR 912.23 ;PCT DEB 1/26/00 $4.00 00-321413
Phone:
Total $54.00
-- -- — –
Contractor:
SOUTHWEST HEATING + AIR
CONDITIONING
1950 NW 119TH REQUIRFD INSPECT"IONS
PORTLAND, OR 97229 ---- --T-___ --
Heating Un! Insp
Phone:626-7479 F i,;al Inspection
Reg #: LIC 128484
This permit is issued subject to the regulations contained i.- the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws All work will be cone in accordance with approved
plans. This pe,mit will expire if work is not started within 180 jays 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 l nose rules are set forth in OAR 952-001-0010 through OAR 952-001.0080
ou may obtain copies at t ;Sele 'or dir�ct gt�r,stions to UUNC by caNirg ( 3)246-11$9.
�
esus By: erm;ctee signature:
Call (503) 639.4175 by 7:00 P.M. for inspections neede the next business day
Plan C
CITY OF TIGARD Mechanical Permit Application Recd ck �-
1312ii SW HALL BLVD. Commercial and Residential Date Rer'd
Tlr'iARD, OR 97223 Date to F.E. '_4
( '03) 639-4171, x304 Date to DST/--
Print or Type PermitaY
Incomplete or illegible applications will not be accepted Called
Name of Development/Pmled Description
Table 1A Mechanical Code Ot Price Amt
Jot) A Permit Fee E,'� '.
Str dross Sulteu� ) 16_00
I 1) r� mace'u 100,000 BTU
Address r SS 5��1� 1tk(yiO including ducts&vents Y`see footnote 1.2 I I 9.(35
Bldg# CByrStRte Zip --
I 2) Furnace 100,000 BTU+
Se, ) 0�_ including ducts_&vents_ see footnote i,2 12.00
Name(or na a of buslness) " 3) Floor Fi i nate
Owner r' X���Z inrlu(,;ng vent _ see footnote i,[ B.Gb
Mailing Address 4) Suspended heater,wall heater `I
or floor mounted heater _ see footnote 1,1 9,65
5) ,, t not included in appliance ermit 4 75 _
Crly/state Zip Phone CheGc that apply �'Eioiler Heat 14
j PJ �971 J 0 - �, For items 6-10,see or Pump Cond City Price Amt
Nam (or name of business) footnotes 1,2 omp -
6)<3HP,absorb unit to
100K BTU 9.65
Occupant ding Address, 7)3-15 HP;absorb unit
100k to 500k BTU_ 17.65
Cdy/State Zip Phone 8) 15-30 HP,absor;,
unit.5-1 mil BTU 24.15 _
9)30-50 HP,absorb
Contractor Name unit 1-1.75 mil BTU _ 36.00
_
10)>50HP,absorb unit
r'rior to permit Mailing Address >1.75 mil BTU 60 15 i
issuance,a copy / r cJ 11 Air handling unit to 10,000 CFM
of all liter:es Cnyfstate Zip Phone _ 7 00 _
are i quireo if A-7 ;- ^(r'Ji� �/ 12)Air handling unit 10,U00 CFM+
expired it COT Oregon Const.cont Board Uc N Exp/Date _ __ _ 11 85 _
database - ( /0 13)Non-portably 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 a vfstate Zip FFhone 16)Hood served by mechanical exhaust
7.00
Describe work to be done:_ 1 7)Domestic incinerators Y W
1200
New O Repi..:r O Replace wt: like kind: Yes-,Q,,'N0 U 1')Commercial or industrial type incinerator
Residents" Commercial __ 48.7.;
19)Repair units
Adodional InformpUon or description of work: 8
20)Wood stove/gas FP/oiher units/clothe dryer/etc.
_ 700
NOTE: For Commercial projects only;Units over 4001t.s.require 21)Gas piping one to four outlets
structuraL as talcs. See footnote 1 _ 3 75
Type of fuel oil U natural gas I' LPG O electric O 22)More than 4�_outlet(each) _ -3-7.5-
Type
7S
Minimum Permit_Fee$50_.00 _ SUBTOTAL v.
I hereby acknowledge that I have read this app;icat;un,that the information v _ 8%SURCHARGE 7
give i is correct that I am the owrer or authorilrc,t agent of �- PLAN RUVIEW 25%OF SUBTOTAL
thee owner,that plans suh°rinr,i are in ermplionri with Oregon State laws _ Required for ALL commercial permits only
--' TOTAL
Slgnaturq Of t; "t
7 %" Other Inspections and Fees:
1. Inspections outside of normal business hours(mininum rhame-two
/t666-ct ainon Name Phone hours) $50.00 per hour
2. Ins,)ections for which no fee is specifically Indicated (minimum
charge-half h^ur) $50.00 per hour
Foonotef+for commercla,projects only: 3. Additional plan review required by changes,additions or revisions to
1 Provide full schematic of ixisl - and proposed gas line and pressure plans(minimum charge-one-half hour)$50.00 per hour
2 Provide drawings to scala showing existiry and proposed mechanical
unrts 'State Contractor Boiler Certification required
-� — ---- --- "Residential A/C requires site plan showing plaCement of unit
I.\mechperm doc rev 9'98
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Li..a: 639-4175 Business Line: 639-4171 -'
( 2 ' f BUP -----
Date Requested AM/ -PM BLD
LocationMEC,
— ► �6 �j r ., ''1� 1� - - Suite f-
..
Contact Person Ph PLM
Contract-r _ Ph SWR
BUILDING Tenant/Owner - - ELC �-
Retaining Wall — ELR
Footing Access- 4-1
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab ---- ------ - ------- SIT
Post& (learn
Ext Sheath/Sheaf
Int Sheath/Shear -
Framing
Insulation
Dry -]Ii 'ailing
Firs wq!'
Fire 5, ,ukler
Fire Alarm
Susp'd Ceiling -------- ---- -
Roof
Mise: -------- --- - ---
Final
PASS PART rAIl. - --- - ---- - -- -- - -
PLUMBING
Post 8 Beam - -- ------ -- - -
Under Slab
Top Out - - -
Water Service
Sanitary Sewer -- - --- - -- - b
Rain Drains
Final
PASS PART FAIL
CHANIG � " > -- -- — �-r,-)!-,t& Beam
Rough In
Foas Line -- - -------- --.�_-_.--- �-- --- —
Smoke Dampers
final --- ------------ -- ------ -_.
CrAo PART FAIL
ELEGTRICAL� ---
--
Service -' ----------- / -
Rough In
UG/Slab
Low Voltage ----------- --------_- -- � _._ _
Fire Alarm ---
Final
PASS PART FAIL -----_.—.- ---�.—_.-__ -- — _
SITE
Backfill/Grading -_-- -- -- -`W —
Sanitary Sewer
Storm Drain [ )Reinspection fee of$- —required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ )Please call for reinspection RE: [ )Unable to inspect-no access
F!re Supply Line
ADA
Approach/Sidewalk / 1
/ -'-�
O�h�lr Date v� 0-� Inspector- VL.%� C) -�_ Ext
3 !n
PART FAIL DO N T REMOVE this in:.pection record from the job site.