9705 SW LAKESIDE DRIVE cfl
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f'/05 SW Lake Sade Drive
MECHANICAL FERMI'
CITY OF T► BARD - PERMIT#: MEC2002 00176
DEVELOP MENT S 'RViCES DATE ISSUED: 5/2/02
13125 SW Hall c3lvd ,Tigard, OR 97223 (503) 639-4171 PARCEL: 2S111;'A-03600
')I''E ADDRESS: 01.)705 SW LAKE SIDE DR ZONING: R-7
SUBDIVISION: `AJMMERFIELC NO.12
LOT. E�56 JURISDICTION_ TIG
SLul.K:
CLASS OF WORK: FLOOR FURN: E'/AP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W10 APPL: 'DENT SYSTEMS.
S1 ORIES: BOILERS/COMPRESSOk S HOODS:
FUEL TYPES n 3—HP.----- v DOMES. INCIN:
LPG 3 15 HP: C:OMML. INCIN:
MAX INPUT: BTU 15 - 30 HP. REPAIR UNITS-
FIRE DAMPEPS?: 30 - 50 HP: V1.iODSTOVES:
GAS PRESSURE: 50 4 HP: CLO DRYERS:
FURN < 100K BTU: 1 —_AIR _HANDLING U14ITS
FURN ;100K ETI.: <- 10000 c,inlGAS OUTLETS:
> 10000 cfm:
Remarks: Installation of furnace. _
Owner: -- -- - -- - _—�__— FEES ------- ��
CARBONE, GEORGE A + MARGUERITE Type By Date Amount^ Receipt
9705 SW LAKESIDE DR PRMT CTR 512M2 $72.50 272002000C
TIGARD, OR 97224 5PCT C i R 5/2/02 $t" 80 2720020OnC
Total $78.30
Phone:
Contractor: _
PIONEER GAS FURNACE
3615 NE BROADWAY
PORTLAND, OR 97232 REQUIRED INSPECTIGNS
Mechanical Insp
Phone: 19 5u00 Heatin�� Unt Insp
Reg #: LIC 36102 Final Inspection
This permit is issued subject to the regulations contai^,ed in the Tigard Municipal Code. State of Ore
Specialty Codes and all other applicable laws. All work will ue done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION- Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-0014'010 through OAR 952-001-0080.
YOU may obtain copies of these rules or direct questions to OUNC by calling (503)246-9'18(+.
Issue By: _ �, t � - I L.__ Permittee Signature: �)
'-SII (503) 639..4175 by 7:00 P.M. for inspectio-s needed the next business day
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�1CC�1i11111'il[ [�C!'Iflll /la[l[1[lCiliM'lll7111tcrmciveU.,r- .
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I(t� .no.: [city of Tigard -- -
�� I Ualelssucd'. _ .__... Illy-,
Ciryo�firard Address: 13125 SW liall Illvd,T1901r,OR t1"11'1.3
!'hone: 'SO3)hay-)1171 (;ase tilt nn,; I'nymrnl wl•,.
Fax: (503)598-1960 I nnlldingpermi:
Land use approval: —
U Mnlli-family 'a'I'rnant inll,rmrvnrnl
rel or nc
fdwr.11inyt a ssary U 0)mincrcill/industrial Jim
&2amily U OIhrr
❑New nstntction U Addition/a.teralion/replacentenl
1
Indicate equipntcnl yuautilics ill boxes hrlu,v. Inllicntc the d,dlat
lob addrex': value of all mechnnical rnalrrinls,r-yuipntrnt.Inhnr,mctltcrld,
Suitt,no`: profit.Valor.$ _ -.------
Tax clap/lax Ic►t/flecount no.: •scc ubecklist for important nppliCatimt int,„nt❑lu,u enol
Lol: Blurk: i tbdivixion: --- jwisdictian's fce schodulr.for residential penult Ice
Project name: _ - ukumlm
-
-
City/county:
pcscriplion and location of wurl.on prcmisev..
Ill Nr+_fmty Ites.mrty
Iaat.datco[compietion/inspuc►ion:
w Airhandlingunit , __ _
Tenn nt ilnprovcntunt nr cita v!d(Ifor coni -Air con Itxn,nii�ilc p as requite )
Is eximinp,sl:ices head d or cundiliuned'1 U Yc J N" -
rnl ono c><slini11V AV RYtrlrm
ho
Is existiltg spaLC im crd?C.1 Yt U No
lcm rrlcompre+cors
r Sole boiler permit on.:
)f•f1L � 1 - _- 1tl' _o4l r.�trilll/I1
Business name:
- j�r�eJgino c ampera r uc`t amn c c e ccToi a
Address:^ (Q G-[�L rn` ' �' FTc"ntpunip(siie all rcquh �li t t ill
it ill i,ll :--- a n.1%IIicp ace nrnacr ,urner db
City- -�r`ax: - 1ucludint;ductworklvcnliin^I
Pltonc: �y�'�'_SD�L� _.I_. _�-_ - nota rep aft rC or.nlehrnlrt� •u•.,nil, I
CCU no.' (,,��7 ._-_.-_ -- - - - wall.or f lour mounted
Cityjmctro lie.nn.: Vatt for a run c otlTer—I -
7_7110! nti 1m_iinrc -
Naw
�t print) ---
1 _-_--
Chillrru
•Nilh ( I Cnm,resaort 111'
v rontnenta ex 1811 aur renlilnl on:
Applinncevcnt .
_. State: ---__—_- —
City - Thyerea taust
-- Plies
Phone: toilfirs• ►yp� f m It,llfh,t l.n Itl
Imod fitesupptcsaiun st 1vu,
1:.ttbaast fan w Ib single dot (baU,tun
Name: m a ran 6om eel nt{�ir�l- -.
Mailing addresr' )q"j(7ti 5th L�IK� F �r^nJ_ I nal dist u1"�iuh to on(hlR) '
- Meat
lypr -
l1ty' IC .li a,1 lila n;,l „�•t nail,Is_� -
--' - — -- v Mai
-_ _____
7 tYmlPtittl;largmu ''i ---
......
Number s1 ocher. --
_ Z/11tcr1ra-t4T p1lnn(-r11 rqo{jnncur.
Itrcnrativeiitcplace _
Arldtt:s I: — ZIP: r -
,. .,_._ nrCrt t
l~talc: _. — .i Op stov 1x�aslnvr ----
_
Phone„
4_.
Applicant'~ -
Name
I',•In,it It•
wlsncli,�llrP„mn,etnlPll,BIIWI. Ibtlltn,ltltlllPl• �' -- 7')• 5 ,
Wailer lpenml npplie Hitm
N„I�a y,ri�ur,rMt+ae:elx credo rnnls,pleue cdl 1 r,><pires if a permit is not uMeiar,l Pian review(nl
l7Vi,n OMaxtaCuul
- - withht ISO days alter ithna been Stair.sort llaty!r IR^R,) . •b _..___ -= ---
credu trod",abet. ucerptrd its to
---tepee e�cu huhkr n,�fiown nn chit e� $ Aro Int I lMlt7n'Ir•',
i C” •a1 o r sl stn rue
IHI111 III In I Il tl•I
MECHANICAL PERMIT FEES
1 73< 2 FAMILY I)WFI LING FEE. SCHEDULE:
COMMERCIAL FEE SCHEDULE: - Prire Total
-_- - Descrip9on: ply I lEa) hml
- -ttt
-- _ _ Table 1A Mechanical n
TOTAL VALUATION: FE
-- -- - 1) Fumaco to 100,00013111 u
--- --,='---- -- M nimum lee$72.50 t 14.00 �•
$1.00 le 55,0.0.00 - -� -" '- `
72.50 for U)e first$5,0011..0 and Includingducts&von a ---- - - - --
51001.00 l0 310,000.00 $ 9) Furnacr, 100,000 D rT 1 1 I Ort
$1 52 for c8rh adds&mal 51600.or
trsrllon thereof,to and ircludin0 _indudinpducts 6 v0111. - -- -
$1Q1000.00. - 3) Floor Furnace 14.00
--- -" inrluding vent
Sib 001 UO to$25,06.UU 5148.t}Q for the 11re1 X10,)0000.sed �`
$1 54 for each culdiliional$100•.0 or 4) 5u,r 1p „^ Ip ne�c ed healer,well herder 1400
fraction thereol,to 8nd it eluding or fluor mounted hoater
- nt Included ia{>+llance1)(111111�25r ROL000-0c
he first$25,)00.00T.xi
$25,001 A0 to$56,06..00 $174 r fort enor oh midilionn'$ UO 00 or 0) r„polr unHg-- - - --12.1
-
froclior t1 l0 and itcludb)p _
leoll
$50,000.00• - Check 811 that- -apWY - Uuiler 11eni Al,
-' - $742.00 for the first$50,J00.00 aril For iteml;7-11,Seo or f'I I'll, Gond
$50,001.000 ant?'1" $1.20 for each additiono $100.00 Or
fracthn thereol• tootnolos below. Camp*_ ----
_ - 7)c31�'{r attNorb unit _ 1400
- -- h 100K IIT. - - - - --- -- -
SSUMEQ VALUATIONS PER APPLIANCE: _ 1)3.15 HP;absorb 25.130
A
-- --- -- V81ue Total ,,nit 100k to 500k BTU _- ------
Amount gj 115.30 Hf;absorb
15.00
DescripliQm - 955 unlit.5.1 trill BTU
Furnnco to 100,00013'1 InUuding r 10)30.50 hlf;absorb q2 p0
ducts 81 W"Its _ _ _. _-__ -
1,170 unit 1-1.75 rpil BTU _ --
Furnace> 100,000 B1'U Including _ - 11)>501 If' -- T 137 2u
ducts 8 vinl� --
- 955 __ unH>1.75 mil BTU-
Floor furnace Including.venll - __ --
_ 1x35 12)AIr handling unit to 10,000 rrM 10.00
Suspended heatur,wall hoater or
_ - -- ---. _._ _0_000__..
13)Alr handling Iplil 10,0.0
floor muunclu hoater llcsne - _ 445 17.20
CINll
Vent not included In app _ -�-
ponnll 14)Non porlable evnporstc cuninr 10.00
�elr units _ -_ --. -
<3{•p;absorb.unlT, - r -'-`
to 100k B1"U -151 Vont fan connected lu a single dual^- r;,ti0
1,700 -
3-15 hhp;absorb.unit,^ _- 16)Vontllallon system nal Included It,
Iq OU
101k to 500k BTU_ _ - ---- _
•- . W 2 310 a )Ranco
15.3011p;8b4orb.unit,501k to 1 17 )Hood served by morhanlcnl axhaii�l to 00
mil.BTU -
30.50 hp;absorb.unit, - Ott)Dom`eslic Inalner8lors 17.40
1-1.75 mil.BTU .- - _ . - .- G,725 - - 7
>50 ftp;absorb,unit, - -
>1.75 trill.BTU _ ----- -- 19)Commercial or Industria)type incineralnr 09.95
_- 0___000_._.� _ _ -- ---- -
058
Air handlIN unit to lyuod0 cfm.__ _ 170 20 Other units,Including wood stoves 10.00
Air handling unitt-110,000 cfm -- -�65� - - ) _ - _ _ -
Nnli�orta�le evaporate cooler_- - A40 --- - 91)c38s piping one to fnur oullel9 1140
Vont fon connocled to a sin to dt!?t
0
56
- _ ---
Vont system not Included in - _ 22)More than 4-per nutlet(each) 100
aPPllan�ermit-, 0,00_0. --- -`050
Hr d served mechanical exhaust _-1 T O _ Minimum-�rmIt reo 572.5. 9UfITOTAL: -
Domestic Incinerator - - -00_00 0 590 - -- �-
-- _
-r -050 - -_. -- -- ---- --
_Commercial or industrial Incinerator _•Y - 8�/.State Surcharge
Other unit,Including wood stoves, y 5=��
Inserts,etc. _. -- -- -300 `- 255%.plan Revlew Fen(of su total) $
C3as�71 Iing 1 4 outlets - - 01 - Rprlulrccl Inn Al I rnnrnerdal pennlls ur,l� - -
Each TOTAL 8ddilicx-►nl
---
_- -
_ _ _ _ ---- $ 70•tAL RESIpENTIAL PERMIT Ff..
COMMERCIAL
VALUATION: _ - -- - - - - --.- giber r I st,abunns and f ten
_ .
1 Inspection%rut''-,1'In"f 1-11".01 I•'„' Iu11 rt Int n'n Cpn r.h 11 gn IWn 1101114)
$72 50 per Ir;lir r.ell t„1tr:n1r11 (nlinnnun,rhv0a'1011 haul I
' Innpuotloan lot W11101 nn Ire I9 r.l• v
$72 50 ler hour
3 Addlllonnl plan rovlaw ruyuirad' rhgnde�.nitdfllnna nt rnvlRlnns to plan%hill''"''
dmlge-ane hall linin)$72 5t)per hnur
"Slate contractor nollw(:arlHicallon renolmd for units>10nk 81"
"Residential AIC renulnes site plan sho,nlan placement of unit.
I:1dst5\IcrinsVnech-fees.duc 10111100
CITY CSF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175
INSPECTION DIVISION Business Line: (503) 639-4171 �, ST
��}( aUP -Re-lived _- Date R uested __ AM_ _ PM -_>L BUP
J
Location uite_.o_ -- MEC
Contact Person ._ - _ Ph( ) _ PLM
Contractor - - _ -- - - Ph(--) -P- -- cJf, SWR -- ----
BUILDING_ Tenant/Owner -_-_ _-� -_ ELC
Footing -
Foundation FL`'
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Nutc;�.;--__—_____-__—__.___._—_.__ SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
- <
Int Sheath/Sheer -
Framing -
Insulation
Drywall Nailing -- - —--
Firewall �_ l
Fire Sprinkler
Fire Alarm
Susp'd Ceiling - —
Roof
Other -
Final
PASS PART FAIL
Under Slab --- -
1
Rough-In
Water Service lei
Sanitary Sewer
Rain Drains --
Catch Basin/Manhold ;
Storm Drain ---- -- - --- -
Shower Pan -
Othe
Final
PASS ART FAIL
----------
MECHAN
os Beam _..--
Rough-In ---------_. _ -- - --- - ---
Gas Line
S oke Dampey>; -
it
S�P RT FAIL ---------... ---- -�.-.- ---
E IC
Service --'
Rough-In
UG/Slab --- - .T.-
Low Voltage
Fite Alarm -- -- --- ----- __-------- ----
Final Reinspection fee of$ _-- required before next Inspection. Pay at City Hall, 131:5 SW Hall Blvd.
PASS PART FAIL
SITE _ _ Please call for reinspection RE:------- _.--_ lJ Unable to inspect-no access
F re Supply Line
ADA
Approach/Sidewalk Daft Inspector � _—_- _Ext
I
Other-
Final DCS NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL