Permit CITY OF TIGARD
MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC2001 -00073
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
DATE ISSUED: 2/27/01
PARCEL: 2S 112BD -00700
SITE ADDRESS: 14655 SW 76TH AVE 008
SUBDIVISION: MARCIENE II ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS: 6
OCCUPANCY GRP: R1 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 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 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: This permit is for 1 1/2 hours of inspection time to inspect the installation of vent fans in units 8, 9, 10, 12, 13 &
14.
Owner: FEES
BOOTH - HEYDON LLC Type By Date Amount Receipt
PO BOX 1185 PRMT CTR 2/27/01 $93.75 2720010000
LAKE OSWEGO, OR 97035 5PCT CTR 2/27/01 $7.50 2720010000
Total $101.25
Phone:
Contractor:
STEVE REGALADO
13935 SE CALLAHAN RD
PORTLAND, OR 97236 REQUIRED INSPECTIONS
Misc. Inspection
Phone: 503 - 702 -8459 Final Inspection
Reg #: LIC 100271
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 ; 0010 - through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to_OUNC by
calling'(503)246- 9189.
Issue By: 1K. g,44 Permittee Signature: y- /
Call 0503) 639 -4175 by 7:00 P.M. for inspections needed thZext business day
' Mechanical Permit Application
Date received: m" . A hi - Permit no.: � ..e
1'ti " City of Tigard
1 g Pro ect/a t no.: `
j pp . o.: Expire date:
CitynjTigard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 639 - 4171 Date issued: By: Receipt no.:
Fax: (503) 598 - 1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF PERMIT
❑ 1 & 2family dwelling or accessory 0 Commercial/industrial l: Multi- family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: /5/6_575 ef) 7 , frc,' 9 ` /' { /5 y-/ L L Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suit6' no.: ' value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: !Block: 1 Subdivision: *See checklist for important application information and
Project name: • jurisdiction's fee schedule for residential permit fee.
City /county: ZIP: 1 & 2, FAMILY DWELLING' PERMIT FEE SCHEDULE'
Description and location of work on premises: AND COMMERICAL/INDUSTRIAL EQUIPMENTSCHEDULE
Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes ❑ No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
'MECHANICAL CONTRACTOR , • •' Boiler /compressors
Business - name:: (--L L; . `" �� /� ti360 State boiler permit no.:
Address: ` / `jC� 3 $ s �- (I /t. LA1��� HP Tons BTU/H
� �-' L F ire smoke dampers/duct smoke detectors
City: e y1 [State ,7, ZIP• 7/34,, Heat pump (site plan required)
Phone: 7�Z- r r
" ' E - mail: Install/replace furnace/burner BTU /H
CCB no.: Including ductwork/vent liner 0 Yes 0 No
� 9'� lnstallreplace /relocate heaters suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): _5� /6- �`� �/J' -/1�,� Vent for appliance other than furnace j
' CONTACT PERSON .• • Refrigeration: • Absorption units BTU/H
Name: Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: [State: ! ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
OWNER.
Hoods, Type U II/res. kitchen /hazmat
//, �� hood fire suppression system
Name: /LLa g " cc.-- A - g".2 - t Exhaust fan with single duct (bath fans)
Mailing address: /69O 501 , 71 /) Exhaust system apart from heating or AC
" Fuel piping and distribution (up to 4 outlets)
City:�� ' ,C( ! ate 1,/'IZIP: f ,Z; 7_7 Type: LPG NG Oil
Phone: , )— / Fax: E -mail: Fuel piping each additional over 4 outlets
, ENGINEER ., • ' , Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: • • 'State: 'ZIP: Insert — type -
Phone: 1 Fax: 1 E -mail: Woodstove/pellet stove
Other:
Applicant's signature: . ( Date: Other. / r
Name (print): 7
Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ �` / —
Notice: This permit application Minimum fee $
❑ Visa ❑MasterCard expires if a permit is not obtained
Credit card number: / / Plan review (at %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ 2, `;"e-
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $ , P.5
Cardholder signature Amount
440 -4617 (6/00 /COM)
•
CITY OF TIGARD BUILDING INSPECTION DIVISION
-24-Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested 3 - /s- 0/ AM PM BLD
Location / Suite MEC ;Oen _ 00013
Contact Person Ph j, -: - — - -
Contractor EL E 1 P,F /vV ; Ph (S' - 8i36. SWR
BUILDING Tenant/Owner 4
Retaining Wall E
Footing , •� �-- �- �--- }6 {-�, ��
Access:
Foundation L p 1 F'S
FtgDrain NITS d - � / C I (S n�
Crawl Drain Inspection Notes: _ � SGN
Slab t9, i f S _ - - - 7 SIT
Post & Beam
Ext Sheath /Shear i! I/'/ S / S /r1/4/ f� ®� / �
Int Sheath /Shear
Framing
Insulation 6 Q
Drywall Nailing
Firewall 5.3 `/3 ? S
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
. Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam �` A/ 7 3
Under Slab / Y
Top Out
Water Service
Sanitary Sewer . /l /
Rain Drains w
(((( tJ . /V -
Final
PASS PART FAIL
MECHANICAL CA 5
L
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
_BASS --RATT FAIL
(jELBCTRICJL)
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
1 n ,
C I" PART FAIL
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 > f
Approach /Sidewalk Date 3 / / /� / / Inspector /' / Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.