Permit (129) r
410... CITY OF T MECHANICAL
PERMIT
% n,,, i ,,,, DEVELOPMENT SERVICES DATE I ISSUED: 11 /
• 1 MEC97-0456
i vionid 1 ' PARCEL: ES115BA -00101
SITE ADDRESS...: 16200 SW PACIFIC HWY
SUBDIVISION ZONING: C —G
BLOCK • LOT . JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP : 0 DOMES. INCIN: 0
:GAS 3 -15 HP • 0 COMML. INCIN: 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: 0 <= 10000 cfm: 0 GAS OUTLETS.: 3
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Run gas piping in spec space
Owner: FEES
TIGARD TOWN SQUARE type amount by date recpt
16200 SW PACIFIC HWY PRMT $ 25.00 JSD 11/19/97 97- 301077
TIGARD OR 97224 5PCT $ 1.25 JSD 11/19/97 97- 301077
Phone #:
Contractor:
KEEFER PLUMBING
52300 SW SOUTH RD
$ 26.25 TOTAL
GASTON OR 97119
Phone #: 640 -7451
Reg #..: 056481
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 Final Inspection
applicable laws. All work will be 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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 - 001-0010 through OAR 952-001-0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246-9187.
■IIII' 4 11111 A'
Issue By: - -- A rak Permittee Signatu e:9/ / / ilk ��. VI I ' .'4_ r
vy, ++++++++++++++++++++++++++++++++++++++++++++++++ + ++ ++ + + + + + ++ + + + ++ + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + ++ + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By ��
13125 SW HALL BLVD. Commercial and Residential Date Recd / f iy
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # /M - ( :C D -0-6
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address P k •
Suite# A) Permit Fee -0- -0- 10.00
Address I (O g# 7�C�Sl c� �y Zip "
dd 1.) Furnace to 100,000 BTU 6.00
T c,a.,a C I 7723 including ducts & vents
Name � (orr name of business) ✓n 1 2.) Furnace 100,000 BTU+ 7.50
Owner L spa S C�h a
Vo..QA t4cjL J - including ducts & vents
MaiWdtess 3.) Floor Furnace 6.00
l ` 0 L eX including vent
- City/,Slat C Zip Phone 4 Suspended heater, wall heater 6.00
�i or floor mounted heater
Name (or name of b 5.) Vent not included in appliance permit 3.00
(. Sew
Occupant Mailing AddiEit 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City/State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
C Jl 15-30 HP; absorb unit5-1 mil BTU"
Prior to permit Maill Address c 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy 23 O O 5 (.(3 �i ( VitA PAO 30-50 HP; absorb unit 1- 1.75mil BTU"'
of all licenses are required if WState Zip
S '�.t.f (r) ,r (^ Phi "r(� 10.) Boiler HP; abso u n i pump, air cond. 37.50
> 50 HP; absorb unit 1.75 mil BTU"
expired in COT Oregon Const. Cont Board Lic.# 1 Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database (D5 3 -31- q g
Architect Name 13.) Non - portable evaporate cooler 4.50
Or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City /State Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential tQ
Additional Description of work: 17.) Domestic incinerators 7.50
- �4
ff-W -W S LZ .e '�' � L - V i ce_Cycr5f.
C /` f k 18.) Commercial or industrial type 30.00
is- S (k VLt j Incinerator
Existing use of f . i 19.) Repair units 4.50
building or property ' ( 1 i N) Cs) .t��. .t/-
20.) Wood stove 4.50
Proposed use of � 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas. LPG 0 electric 0 23.) Gas piping one to four outlets 2.00 o
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50 `(�
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Signature of Owner /Agent Date *SUBTOTAL .-rA/ /7
n (1 (Q q 7 5% SURCHARGE
I
Contact Pers Na a Phone PLAN REVIEW 25% OF SUBTOTAL
(_ `F' �0 r te ]/ (,� TOTAL
/C'CC/
�l� �(J I �-J 1 k- / )
i:trnechpmt.doc (re 9 *Minimum permit fee is $25 + 5% surcharge
"Residential A/C requires site plan showing placement of unit.
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CITY OF TIGA D
�,uD�N� ��� 4a- 4
\P Approved [ .
tonditionai:y Approved
r or only the work as descr� �pj�/ [ ]
4"ERtv111 NO. See Letter to: cHow
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slob Ad .- . d it,
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•
6/30/99 Activities for. Case #: MEC97 -00456
4:44:17 PM
Assigned Hold Updated
Activity Description Date I Date 2 Date 3 To Done By Disp. Level . By Updated Notes
MECC007. Application received 11/19/97 JSD PASS JD 11/19/97
MECC008 Permit created • 11/19/97 JSD PASS JD 11/19/97
MECC799 Final Inspection 4/28/99 180+ JT 4/28/99 inspection request/researach
sent to Hap W. •
MECC705 Gas Line lnsp 11/19/97 11/20/97 MS FAIL MRS 11/21/97 not sufficient pressure
MECC090 (F) Issue permit 11/19/97 JSD PASS JD 11/19/97 Plans presented to Jim Funk
who indicated it was okey to
• issue.
MECC800 Case Finaled 4/29/99 AKJ DONE No Hold AKJ 4/29/99
MECC799 Final Inspection 4/29/99 4/29/99 4/29/99 TLP PASS No Hold AKJ 4/29/99
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Page 1 of 1 -
/-11, CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested AM PM BLD
Location x
1 aO6 Suite / \ MEC Fick
Contact Person Ph PLM
Contractor Ph SWR
BUILDING � ena Owner ,/ # �L ��� ELC
Retaining Wal l ELR
Footing Access:
Foundation / 1, FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall /� c
Fire Sprinkler �"��Q� r �l��l ` �
LGI� "e0
Fire Alarm 6;(--
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer •
Rain Drains
Final
P FAIL
ECHANI��►
Rough In
Gas Line
Smoke Dampers •
• PART =:7:
ELECTRICAL
Service
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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Wg. il nspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.