10491 SW LADY MARION DRIVE 1
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L049L SW LADY MARI(Y.4 DRIVE
CITYOF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC199�100548
13125 SW Hall Blvd., Tigard, OR 9722:, (503) 639-4171 DATE ISSUED: 12/09/1999
PARCEL: 2S 111 CB-04"00
S TE ADDRESS: 10491 SW LADY MARION DR
SUBDIVISION: MARION ESTATES ZONING: R-3.5
BLOCK: LOT: 015 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNI if HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
IN IAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS?: 30 - 50 HP ODZI- UNITS:
WOOD;'
GAS ^.ESSURE: yp + N ,; TOvES:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
OTHER UNITS: 1
FI MN :-i(1101( BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 Cf m:
Remarks: Inst ,has piping to log set in single family dwelling.
Owner. � FEES_ V _
CAMPBELL. DONALD G + PAT-0 B type By Date Amount Receipt
10491 SW LADY MARION DR PRMT CJN 12:09119 $50.00 99-320311
TIGARD, OR 97224 5PCT KJP 12/09/19 $4.00 99-320311
Phone: Total _ $54.00
Contractor:
PACIFIC GAS WORKS
PO BOX 30641;
PORTLAND, OR 97294 _ __ RFQUIREU INSPECTIONS _
Gas Line Insp
Phone: 503-317-5573 Misc. Inspection
Reg M LIC 136391 Final Inspection
ORIGINAI-_
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 appr.-.,2d plans. This permit will expire if work is
not started within 180 �ays 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 ,enter. Thcse rules are set forth in OAR
952.-001 .0010 throng O�R 952-001-0080. You may obtain conies of these rules or direct questions to OUNC by
calling (503)246,918 /J
Issue By: ;/ ,' - JZ i1� a-,�_ Permittee Signature: =
Call (503) 639-4175 by 7:00 P.M. for inspections nRgdtll'd th: next business day
Plan Check#
CITY OF TIGARD Mechanical Permit Application Recd By _
13125 SW BALL BLVD. Corr.mercial and Residential Date Recd
TIGAI'D, OR 97223 Date to P.E.
(503) 639-4171, x394 Date to DST
Print or Type Permit#r71iow-60yy
Incomplete or ill .3le_applications wiil not be accepted Called —
Name of Development/Pro)ect Description
Table 1A Nlechanical Code _ — Qty Price Amt
Job street A,,races sultep A) Permit Fee .,,1 16 00
p / 1) Furnace to 100,000 BTU
Address �,% /� 'Ci1�� %� including ducts&vents see footr,)le 1,2 9.65i _
Bldg# CnylState zip 2) Furnace 100,000 BTU+
including ducts&vents see footnote 1,2 12.00
Na or name of busines 3) Floor Furnace
Owner l� p`y�% including vent ____see footnote 1,2 9_65
Mailing Address 4) Suspended heater,wall heater
n or P.aor mounted heater_ see footnote 1,2 _ _ 9.65 _
5) Vent not included in appliance:permit _ 4 75_
cny tate zip' Phone 111 Check at that apply. 'Boiler Heat Air
I�7ez :�L -�'�� For ite no e. .3,see or Pump Cond Qty Price Amt
a a for name of business) footnotes 1,2 Comp
N
6)<3HP;absorb uni'.to
100K BTU _ 9.65
Occupant Meiling Address 7)3-15 HP,absorb unit
100k to 500k BTU 17.65
Cdy/State Tip Phone 8)15-30 HP,absorb
it.5-1 mil BTU 24.15
9)30.50 HP,absorb
Name
contraC,,)r unit 1-1.75 mil BTUI _ 36.00
10)>50HP,absorb unit
Prior to permit M 9n Addass >1 75 mil BTU �_ _ 60.15 _
issuance,a copy J�'/ 11 Air handling unit to 10,000 CFV
of all licenses Ct}y tete zi Phone _ __ _ 700
are requi,ed 9 r 317_<5 7_3 12)Air handling unit 10,000 CFM"i
expired in COT Oregon Const Cont Board Llc# xp ate 11.85 _
database / .lc / jd 04 13)Non-portable evaporate cooler
Architect Name 7.00
14)Vent fan connected to a single duct
Or Mailing Address _ _ I 4.75 __-
15)Ventilation system nut incl ided in T
_appliance permd 7.)0
Engineer cnyrstete zip Phone 16)Hood served by mehanical exhaust
7.00 _
Describe work to be done: 17)Domestic incinerators
1200
New O Repair O R:place with like kind Yes O No O 18)Commercial or industrial type incinerator
Residential �;ommercialO 48.25 _
19)Repair units
Additional information or description of work ___it t:40 —
��� C 20)Wood stove/gas FP/other units/clothe dryer/etc.
7,00 7
NOTE: For Commercial projects only;Units over 400 lbs.require 21)Gas piping one to four outlets
structural gas talcs. See footnote 1 __,--- _ 3 75 3 �5
Type of fuel. oil O natural gas-k— LPG O electric O 22)More than 4-per outlet(each) —__ .75
Minimum Permit Fee$50.0_0__ SUBTOTAL
I hereby acknowledge that I have read this application,that the information _ 8%SURCHARGE ,,4gkr:
given Is correct,that I am the owner or authorized agent of PLAN REVIEW 25%OF SUBTOTAL ,
the owner,that plans submitted are In compliance with Oregon State laws. Required for ALL commercial permits only '
TOTAL C
SlgrLare of Owner/Agent _� Date Other Inspections and normal business hours minlnum char's-two
1. Inspections outsideo ( g
Cqn6coMhon Name Phone hours) $50.00 per hour
2. Inspections for which n,�fee is specifically indicated ;minimum
�cf 1 G � `���-may 3/f—s�7 3 charge-half hour) $50.00 per hour
Foorotes for coinfinercial projects only: 3. Additional plan review required by changes,additions or revisions to
1 Provide full schematic of existing and proposed gas line and presswe plans(minimp•m(harge-one-half hour)$50.00 per hour
2. Provide drawings to scale showing exiFling and proposed mechanical
—1-to Contractor P,oiler Certification required
units
- ----- ------ "Residermal,4C requires site plan showing placement of unit
I:lmechperm Ac rev 7119/6)
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
1.4-Hour Inspection Line: 639-4175 Business Line: 639-4171
BUP
Date Regrested �V) PM ,__ BLD
Location /& I � ZL c' JY7 v,L•-. Suite _ MEC 0415--v
Contact Person _ T Ph 31; �S-S 7 3 PLM
Contractor ---_ Ph SWR _
BUILDING — Tenant/Owner ELC
Retaining We" ELR
Footing Access:
Foundation FPS — —
Fig Drain — SGN
Crawl Drain Inspec-cion Notes-.
Slab _— __—__---- _-- -- _-- SIT
Post.! Beam ---
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing — —
Firewall ----
Fi!e SprinklerFire Alarm
Alarm '
Susp'd Ceiling ----------- _—__—_ '� — ---
Roof
Misc —. ----- --- - — --
r-inal - --
PASS PART FAIL ---- —___^—_— —__—
PLUMBING
Post&Beam - "---------------- —. — -- _—�—,--
Under triab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final - ----- — -- --- -------------
PASS PART FAIL
MECHANICAL _
Posteam- - -- - — ------ ---_----.___--___.__--- -------- ----------
R9uphln_
Smoke Dampers
Dampers
Final _ _. - --- -- ----- --- ---
PASS ' A FAIL.
ELECTRML
Service
Rough In
UG/Slab
Low Voltage ---�._-_—
Fire Alarm
_ ------ -- --- -__._----------- -------------------
Final
PASS PART FAIL --- --------.--__-_-- _ _ _-- --_�—__.__ —
SITE
Backfill/Grading — ----- - --- -- — --__.—_____-- _
Sanitary Sewer
Storm Drain [ ]Reinspection fee of$ !equired befure next inspection. Pay at City Hall, 1312"SW I fall Blvd
Catch Basin [ ]Please call for reinspection RE:_. ^—_ [ [ Unable to inspect no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector !;" (� Ext `
Other -�- —�L -- --- —_
Final
PASS PART FAIL CO ►IOT REMOVE this Inspection record frim the joh site.