Permit - ,..,
... -
* CITY OF T MECHANICAL PERMIT
fla DEVELOPMENT SERVICES PERMIT #: MEC2002 -00519
' � I 13125 SW Hall Blvd., Tigard, OR 97 (503) 639 -4171 DATE ISSUED: 1/24/03
PARCEL: 2S 101 AD -01300
SITE ADDRESS: 12750 SW 68TH AVE
SUBDIVISION: WEST PORTLAND HEIGHTS ZONING: MUE
BLOCK: LOT: 033 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: 115 BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: N 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: M 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: 1 < =10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Mechanical tenant improvement.
Owner: FEES
HAMPTON BUILDING, THE LLC Description Date Amount
6803 SW WHEATLAND RUN [MECH] Permit Fee 1/24/03 $72.50
WILSONVILLE, OR 97070 [MECPLN] Plan Rev 1/24/03 $18.13
[TAX] 8% StateTax 1/24/03 $5.80
Phone: Total $96.43
Contractor:
ACCURATE HEATING, INC.
P.O. BOX 2276
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Phone: 650 - 1229 Gas Line Insp
Mechanical Insp
Reg #: LIC 88423 Final Inspection
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 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 -001 -00
Issued By: Permittee Signature: lj \ 5
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application
C)FI I(_ l:til: OVI1
D Date received: // /9 O Permit no.: �.. ,,, / 9
''
,1,11. ,1,11. ° � �� City of Tigard Project/appl. no.: ,.aiiIiii, date:
ay of Tigard Address: 13125 SW Halliptectav g.223 Date issued: Receipt no.:
Phone: (503) 639 -417 IMP
Fax: (503) 598 -1960 Ato" 9 2 O2 Case file no.: Payment type:
Land use approval: 1 � �! . RD Building permit no.:
111'I: ()I 1'11(1111
O 1 & 2 family dwelling or accessory O Commercial/industrial O Multi - family O Tenant improvement
O New construction CI Addi tion/alteration /replacement O Other:
.I si i h: 'N1010111 ION (:011111:1(( 111. 111 Still :I)1 1
Job address: d 27 go 5 fJ - 7 i1v-'- Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.: value of all mechanical materials, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 5 `)CI 6 e .
Lot: Block: Subdivision: *See checklist for important application information and
Project name: A ,' c -ery - k G Ilenisimmi jurisdictionj's fee schedule for residential permit fee.
City/county: '76-A.0 EIMERMEMINI 1 & 2 I :1\I11 1)11I 1'11(1111 1 I : S( Ill DI I.I
Description and location of work on premises: A D a (1.1 1 2 T ( . . ) \ N I ) ( ( ) ,'S I : \ I I : It I ( 1 1 / 1 1 . 1 1 1 i S I 1 t I : I . I : (1 111' \ 11 N i .ti ( 111 U 111
-.S . ' h u ' aced C )Ch S „ Co Lr PI ?L. Total
Est. date of completion/inspection: 1 1 I MEE/ Res.
Tenant improvement or change of use:
Is existing space heated or conditioned ?'Yes O No Air handling unit CFM
Air conditioning (site plan required) Mil
Is existing space insulated?QYes O No r‘171771, , T , . f f . " . T i 1 1 1 ( 1 1 1 N 1 ( 1 1 1 1 . (() ON I R 1(: O I t Boiler /compressors
MMIMIE CC v(fq- / State boiler pern it no.: ,■■
HP Tons BTU/H
Address: /, 2-7.-7 Go Fire/smoke dampers/duct smoke detectors Ell a State: ZIP: 570 / S eat pump site pan regw
Phone: , • L. Z S Fax: SO •ug/S• E -mail: ns : r , ace wnac umer : - 1 ' ■ --
CCB no.: ,f7. -
Including ductwork/vent liner ❑ Yes O No
ns : ► : re ocate - suspen ■ --
City/metro lic. no.: 0 2, , c" c" / wall, or floor mounted
Name (please print): f'C d • ri Vent for : , , fiance other than furnace -
CO I :1C1 I'h:ItSO Absorption units BTU/H 111
Name: ,u j C `Ja £ r e> C. G N A 13 (1 Compressors HP —
Address: 0 ZZ7 c,
e ve , , i" on: ■ --
` .. e EMM Appliance vent
Phone:l.e.Sd -/ 2 i' Fax: E -mail: • er exhaust ME cm Ni it Hoods, Type 1/ Il/res. kitchen/hazmat ■ __
hood fire suppression system
Exhaust fan with sin:le duct (bath fans) -
Mailing address: v c K } Exhaust s stem : , : from heatin_ or AC =
i State: a ZIP: �' T 8° P f NG to out w e l ts ■ --
Phone: Fax: E -mail: ue .1 eac : • , rmon: over - ou ets MIN I : \ (.I \ l 1: It . , , , (schematic required) MIIMMEN
Name: Number of outlets -
el. a i ve fire . l or pmoot ■ --
Address: Decorative fire , lacc e
City: State: ZIP: Insert - type
" • • , tOV , - et stove
Phone: Fax: E -mail: =
Other.
Applicant's signature: Date: ,m. . -
Name (print): -
Not all jurisdictions accept credit cards, please can w
jurisdiction for more information. Permit fee $
O Visa CI MasterCard
Notice: This pemrit application Minimum fee $
Credit card number. 1 / expires if a permit is not obtained Plan review (at _ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $
Cardholder signature Amount 440-4617 (6l(1(wCOM)
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION'DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested AM PM BUP
Location P e Suite MEC � 7
Contact Person IAA-c.e ,C� . l Ph ( ) 5a)i ( i PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab -~
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
JNIctL FAIL
_
nst & eam
Rough -In
Gas Line
u oke Dampers
7 PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final LI Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line ADA Date c Inspector Ext
Approach/Sidewalk
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL