15495 SW 123RD AVENUE a
ADDRESS:
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CITY OF TIGARD PUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 B isiness Line: 639-4171 —
Date Requested (3 /-7 I _AM / PMBUP
BLD
Location ` �f s�LU �r � f�� Suite MEC �`�����-'
�
Contact Person � 1k1sk -INIQU,1-tbira, h 0,)y PLM
Contractor P:t SWR -
BUILDING 'Tenant/Owner ����G ELti
Retaining Wall Y ELR
Footing ACC2SS:
FoundatiorFPS
Ftg Drain ��`! !
SGN
Crawl Drain ,nspecti Notes: e —
Slab -.- - - SIT
Post& Beam
Ext Sheath/Shear -
Int Sheath/Shear
--naming _------ --- -- -- -- - --
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 EMT FAIL -----
- MECHANIC. L __
Post& Beam -- ----- --..�_ -- - - - -----Rough In
In
Gas Line — -------- -- --- --Smoke')ampers
PCTPART FAIL. - -
RICAL
Service --
Rough In
UG/Slab --
F:
Low Voltage
Fire Alarm
? Final
PASS PART FAIL - - -- ---- - ---
SITE
Backfill/Grading
w Sanitary Sewer
Storm Drain I 1 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 Date Inspector_2W/,,--,7 _ Ext
Other --
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYOF T I GA R D MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC1999-00545
13125 SW Hall Blvd.,Tigarc' OR 97223 (503) 639-4171 DATE ISSUED: 12/09/1999
PARCEL: 2S'110C B-01500
SITE ADDRESS: 15495 SW 123RD AVE
SUBDIVISION: ZONING:
BLOCK: LOT: JUFISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: 3F UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
_
FUELTYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HI':
CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS
OTHER UNITS:
FURN > 100K BTU: <= 10000 cfm:
:
GAS OUTLETS:
> '10000 cfm:
Remarks: nstallation of a new gas furnace.
Owner: _ _ FEES
COOLEY, SAM G + MARGARET H Type By Date Amount Receipt
15495 SVV 123RD AVE PRMT GEO a12/09/19� $50.00 KING CITY
KING CITY, OR 97224 5PC1 GEO 12/09/19 $4.00 KING CITY
Phone:
Total $54.00
-
Contractor:
COLUMBIA HEATING, + COOLING INC
PO BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Heating Unt Insp
Phone:624-2704 Final Inspection
Reg #:LIC 00076359
PLM 34-175
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 stalled within 180 days of issuance, or if work is suspended
for more than 180 days. ATTEN HOW Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. -those rules are set forth in OAR 952-001-0010 thr(:,agh OAR 952-001-0080.
You may obtain copies oJthese rules or direct questions to OUNC by calling (503)246-9189.
Issue By: _ %{. Permittee Signature:/%:�lr'�Z
Call (503) 63(4175 by 7:00 P.M. for inspections needed the next business day
DEC-08-99 WED 11 ;19 AM City of King City FAX;503 639 3771 PAGE 2
c Plan Check rt
CITY OF TIGARD Mechanical Permit Application Recd _By�_
13125 SW HALL BLVD. Commercial and Residential Date Recd i?-_b=
TIGARD, OR 97223 Date to P+
(S03) 639-4171, x304 Date to DST ��
Pf ICalled
nt or Type ��
Incomplete or illegible a plications WIFE not be accepted caned
Nemo er 0evalopmentlPmj4r2 Description
Table 1A Mechanical Cod* _ ON Price Amt i
Joba dr -- suNeM A Permit Fee 1600-�
Address46 7 . , 1) Furnas:to 100,000 BTU
BtApY CflyrState — �p includingduds A vents sea footnote 1,2 9.65
G 1Zi 2) Furnace 100,000 BTU+
including duds A vents see footnote 1,2 1200_
N^4(or name-f iness) I 3) Floor Furnace
Omer Inciuo,ng vent— - see footnote 1,2 8.65 y
M nn4 sea ss 4) Suspended heater,well heater
F� � or floor mounted heater see footnote 1,2 9.w,
yJ
-5j Vent not Included in appliance rmit 4.75 _
1,91.1r,sta's Zip/� I"n Check all that apply: "Boiler Heat Air
thm �
OR toot.notes 1,2 Gom
For Items 6-10,goo or Pump Cond qty Price Amt
Nama a ob,slnmA) _ _
(( 6)<31 IP'absorb unit to
rlentils AddresF lY✓ 10oKHIV g.6S
mcupant 7)3-15 HP:absorb unit - —
100k to.500k BTV 17.65
c,tyr3tatsalp Phone 8)15.30 HP;absorb -
unit.5.1 mil BTU X4.15
Contractor e _ 9)3050 HP,absorb -
unit 1-1.75 mil BTU 36.00
1n.)>50HP;absorb unit
Prior to permit r A11SN :1.75 rail BTU _1 60.15
ssuancop
y11 a y `, ` 11 Air handling unit to 10,000 CFM
of all licenses cr u r'hone _ 7,00
are roqulred if i l ti q7��3 12)Air handling unit 10,000 CFM+
expired in COT amson .enio a — rp .t14 11.75
database 5� d D 13)No-portable evaporate cooler
Architect Name
faj Vent far,connected to a single dud
Moiling Address _ 75
or 1S)-Ventilation syslrm not included In
Eli Inner csyrstato —"' zip Name appliance permit 7.00
9 16)Hood served by mechanical exhaust
7.00
Describe work to be done: 171,domestic Incinerators
12.00
New O Repair O Replace with like kind! Yes O No a 18)Commercial or Industrial type Incinerator
Residentiaix commercial 48,25
19)Repair units
Additional information or description of work: 8.40
20)Wood stovelgae FP/other units/clothe dryerIota
7.00
NOTE: For Commercial proiectr,only;Units over 4001bs.require 21)Gas piping one to four outlets
CL structural gas talcs. See footnote 1 3,75
Type of fuel; oil O natural gas LPG O electricO 22)More than 4 r outlet(each) 75
1- Minimum Permit Fee$50.00 UBTOTIIL
`n I hereby acknowledge that I have read this application,that the Information %SU_RC_HARGE
r given Is corred,that I am the owner or authorised Agent of PLAN REVIEW 25°x6 OF SUBTOTAL
.-. the owner,that plans submitted are In tempt ane+with Oregon State laws, Required 101 ALL commercial omits only
J
TOTAL
SI alyre of Own*r/A n Date
Other Inspectiontl lend Fees-
LAJ /2
_ 1. Inspaetlons outside of normal husiness hours(minlnum eharga two
Fact Amon N Phtine hours) $50.00 per hour
`rQ t 1� 2. Inspections for which no lee 1%speclflcalty Indicated (minimum
( Z—._ charge-halt hour) $60.00 per hour
i Foonob"for eornmerch.. ro acts only: 3. Additlonal Ian rtrvlew required than es.additions or mvlglons to
i N � y� PM' A
j 1 Provide full schematic of existing and proposed gas line and pressure. plana(minimum charga.one-half hour)$50.00 per hour
2 Provide drawings to Reale showing existing end rmoosed mechanical
units. _ _- "State Contractor Poller Certification required
Residential AIC requires site plan showing placement of unit
1:lmechpe►m,doc rev 0214199