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10725 SN DERRY DELL COURT
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-1-10ur Inspection Line: 639-4175 Business Line: 639-4171 -----
BIJP
TDate Requested �� AM�.-_ PM _ 3LD _
Location— /' Z' / �� a _ ,Suite MEC 0
C,-)r-.tact Person �� i -� Ph _- (D`tel-a- ( _ PLM
Contractor Ph7) (d S SWR
BUILDING _ tenant/Owner ELC
Retaining Wall - ELR
Footing
Foundation Access: ��
FPS
Ftg Drain \cam =
Crawl Drain Inspection Notes: SGN
Slab
Post&Beam --T -- SIT
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation --
Drywall Nailing
Firewall
Fire Sprinkler
-----------
Fire Alarm
Susp'd Ceiling _ �—
Roof / (�
Mise - -�v �_ (�'t�►�t�s2' ", -,,
Final
PASS PART FAIL 7 OILC ed
PLUMBING
Past& Beam -
Under Slab
Top Out y
Water Service
Sanitary Sewer - -
Rain Drains
Final - _ - --- -
PASS PART FAIL
MECHANICAL --
Post& Ream --- __
�Smok Dampers —
Tina_jrK - - - -- -- --
SS PART FAIL
ELEL-TRICAL --
�arvic.•e �.
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 [ J Please call for reinspection RE —__ [ ]Unable to inspect-no access
ADA
Approach/Sidewalk ' l
other _ Date Inspector Ext
Final
1
LP-%SS PART FAILS DO NOT REMOVE this inspection record from the job site.
CITY O TIGARD MECHANICAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard, OR 97,123(503)639-4171 F'ERM i'f #. . . . . . . : MEC99-0088
DATE ISSUED: 03/02/99
PARCEL: '2'S 103DA-01500
SITE ADDRESS. . . : 10725 SW DERRY DELL CT
51JBD I V I S I ON. . . . : DERRY DELL PLAT 2 ZONING: R-3. 5
BLOCK. . . . . . . . . . . L0T. . . . . . . . . . . . . W15 JURISDICTION: TIG
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAP COOLERS: 0
TYPE Oc IJSE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPFi^JCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STO.�iES. . . . . . . . : 0 BOILEPS/C0MPRESS0RS HOODS. . . . . . . : 0
FUEL_ TYPES-------.------- 0-3 HP. . . . : 0 DOMES. i Nu I N: 0
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----------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 1 ( 1.0000 0:m : 0 GAS OUTLETS. : 1
FORK ) =100K BTU- 0 > 10000 cfm : 0
R e m ai•k s : Replace oil furnace witl nem qas furnace, and add gas piping.
Owner-: ------ _------- ----_-- --------- -- - FEES
BRIAN FRAINEY type amoI.tnt by date recpt
10725 SW DERRY DELL_ CT PRMI E 25. 00 GEO 03/02/99 99-313369
TIGARD OR 972-124 SPCT $ 1. 25 GEO 03/02/99 9-9-31-3369
Phone #:
Contractor: -__.__________..-._-------__._..---•---_...-.
ARKEN ENTERPRISES
32045 9 KROPF ROAD __.___.-----___.._...-----__.________---•--___-.- �
f 26. :15 TOTAL
CANBY JP. 97013
Phone #: 651-2137
Reg #. . : 00104.3
------- REQUIRED INSPECTIONS ------
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating 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 IN days of issuance, or if work is suspended for yore
than 188 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are �- —
set forth in OAR 952-@@i-NII Virough OAR 952-001-A@8@. You may
obtain copies of these rules or direct questions to OIW by calling v-
15@3?246--9187,
IssUe BY;. Permittee Signati_tre: _
+++•++-L+++++++++++++++++.f•+++++++++++++++++++++++++ ..++++•F+++++++++++4•+++++++++++4
Cal 1 639-4175 by 7:00 p. m. for• inspect ions needed the next b�_ts i ness day
li++++++++4++•++++++ �++++i•++++++++++++-► ++++++++++++++++++++++++++++++++++++++++++
CITY OF TIGARD Mechanical Permit Application Plan Recd BBy #
y
i 3125 SW HAIL BLVD. Commercial and Residential Date Recd_
TIGARD, OR 97223 Date to P.E _
(503) 639-4171, x304 Date to DSTi
Print or Type Perm'*tl
Incomplete or illegible applications will not be accepted Called
Name of DevelopmanUProject Description —�
Table 1A Mechanical Code ON Price Amt
Permit Fee
A)
job Street Address A. SufreN 10.00
1) Furnace to 100,000 BTU
Adttress - 5•K� . includingducts&vents see footnote 1,2 6.00
BIdgN C;tylState Zip 2) Furnace 100,000 BTU+
fOLV _ including ducts&vents see footnote 1,2 7.50
Name(or name of busJpess) 3) Floor Furnace
Over ' ,Q//�N �-IQ /N� y including vent see footnote 1,2 6.00
Mailing Address T- —� 4) Suspended heater,wall
or floor mounted heater see footnote 1,2 6._00
i 1 5) Vent not included in appliance permit
yY/8121166 Zip Phone 3.00
jet Check all that apply Boiler Heat Air
Name(or name of business) nor Items 6-10,see or Pump Cund Qty Price Amt
51 - footnotes 1,2 Comte ••
��7/` __ 6)<3HP;absorb unit to
Occupant Melling Address — 100K BTU _ _
6.00
7)3-15 HP;absorb unit --
CRY/Shite Zip Phone 100k to 500k BTU_ 11.00
8) 15-30 HP;absorb
COI1trACtOr Name
---- -- unit.5-1 and BTU 15.00
/411( _
lj( !J N ,JjQ/S/- S 9)30-50 HP;absorb
�_ unit 1-1 75 mil BTU _ 22.50
Prior to permit M Iln Address 10)>50HP'absorb unit _
issuance,a copy c/ .5 re *� .0 >1.75 mil BTI 37_.50
of all licenses CRYlStale tip Phone ,r 11)Air handling unit to 10,000 CFM
are required if (-/ /`J�J ��Q 4 50 _
expired in CUT Oregon Const.Rbrlt, nerd Lk N Exp.Date 12)Air handling unit 10,000 CFM+
database i - ('i7 _ 750 _
Architect NBf1e d, 13)Non-portable evaporate cooler
_ 4.50
or Melling Address 14)Vent fan connected to a single duct
3.00
15)Ventilation system not included in
Engineer cnyrsiete Zlp Phonr— appliance permit 4 50
_ 16)Hood served by mechanical exhaust
Describe work to be done0 �/ /,s 67013
� 4.5_0
0 7" 6 17)Domestic Incinerators
New O Repair O Rsplacr+with like.kind Yes O No O 7.50
Residential t5 Commercial n 18)Commemial or industrial type incinerator
3000 _
AdddioRal InforTnation or descripUo of work: 19)Repair units
2 t c 4.50 —
rJ�7 VA 201 wood stove
NOTE o me Ial projects only;Units over 400 lbs require 4.50
structural gas talcs / 21)Clothes dryer,etc.
Type of fuel. oil O natural gas , LPG O electric O _ 450
22)Other units
I hereby acknowledge that 1 have read this application,that the information 4.50
given is correct,that I am the owner or authorized agent of 23)Gas piping one M four outlets
the owner,that plans submitted are in compliance with Oregon State laws See footnote 1 200
24)More than 4-per outlet(each)
Signature of r/Agent Date 50
Minimum Permit Fee$25.00_ SUBTOTAL k'
'lContect Person Name Phone V�
�� _'J 2 _ 5%S_URCHAPGE
I J ��' Sl / �' _ PLAN REVIEW 25%OF SUBTOTAL
Foonotes for commercial projects only: Required for ALL commercial permits only
1 Provide full schematic of existing and proposed gas line and pressure TOTAL
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
1 lmechperm.doc rev 0214199