Permit r
• CITY or TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00018
1— 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/12/2005
PARCEL: 2 S 111 AD -13000
SITE ADDRESS: 15025 SW 89TH PL
SUBDIVISION: SCHECKLA PARK ESTATES ZONING: R -4.5
BLOCK: LOT: 029 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Gas furnace install.
Owner: FEES
FURUKAWA, THOMAS T AND Description Date Amount LE Y
E 50 5 89TH PLACE 8% [MECH] Permit Fee 1/12/200; $72.50
TIGARD, OR 97223 [TAX] 8 State Surchart 1/12/200. $5.80
Phone: 503 774 - 3281 Total $78.30
Contractor:
EASTSIDE HEATING + AIR CONDITIONING
7200 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone: 503 774 - 3281 Final Inspection
Reg #: LIC 3258
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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By: A l., Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Jan 11 05 04:23p Eastside Heating 503 -- 774 -3057 p.
's1 . -7 N
Mecha�nicalPe ` Application OFFICE' USE ONLY
EE1VE
Date received:/ — /a-- Ot/ Permit no.: 0 . De?;J
�. ' 4 . p . . City of Tigard (; Project /appl. no.: Expire date:
City of T igard Address: 13125 SW Hall Blvd, Tigard OR 97223
Phone: (503) 6394171 ►JAN 11 1005 Date issued: By:a) I Receipt no.:
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: CITY OF TI ARr) Building permit no.: 7 //,
fiti & 2 family dwelling or accessory 0 Commercial /industrial 0 Multi- family 0 Tenant improvement
0 New construction Addition /alteration/replacement 0 Other:
JOB SITE INFORNIATI()N CONIMERCI4L VACUA] ION SCHEDULE
Job address: gb_ -- dr Indicate equipment quantities in boxes below. Indicate the dollar •
Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: ' profit. Value S .
Lot: 'Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City/county: --t Car I ZIP: q 7-9--14 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and loation of work on premises: � 5-1-ex t j AND COMNIERICAL /INDUSTRIAL. F Q1!IPMENTSCIIEDULE
9 S +1,, ,, Ct i'.P - -( Wi ! J., � f 4 /.r I 7. .-1.4... Fee (ea.) Total
Est. date of completion/inspection: d t1 Description rip Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM _
Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MECHANICAL CON1 R.ACTOR Boiler /compressors
C 4 . State boiler permit no.:
Business name:
G��1t5 Ir�P HG�TI!?f] Ir rem HP Tons BTU/H
Address: 0 5_�.. ,G - ,hv u I
t urn ,,<. A/u Fire/smoke dampers/duct smoke detectors
City: �-' - / , n State: OR ' ZIP: Heat um
Q � f pump (site plan required)
Phone:SU3 775 ')J) Fax :7T` / ( 7 E- mail: Install/replace furnace/burner j! BTU /H
CCB no.: p Including ductwork/vent liner C) Yes IS No i
t'�l _ Install/replace/relocate heaters - suspended.
�02 y
City /metro lie. no.: 7 wall, or floor mounted •
Name (please print): Vent for appliance other than furnace
CONTACT PERSON
Refrigeration:
Absorption units BTU /H
Name: OPT, h f t vYl.a y-- Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City:
I State: 1 ZIP: Appliance vent
Phone: Fax: E -mail: Dryer exhaust
Hoods, Type 1/ II /res. kitchen/hazrnat
hood fire suppression system
Name: F r- IA_ k a L.,_) Exhaust fan with single duct (bath fans) _
Mailing address: T Exhaust system apart from heating or AC
City: State: ZIP: Fuel piping and distribution (up to 4 outlets)
Phone: ..a Fax: E -mail: Type: LPG _ NG Oil
Fuel pipingach additional over 4 outlets
Process piping (schematic required)
N ye; Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: lnsen - type
Phone: Fax: 1 I E -mail: Woodstove/pellet stove i
Other:
Applicant's signature: � i 4,,1 , . Date: 7.1/ 6 ? 5 Other:
Name (print): A y, e i t-.x � e ■- ire , 4_ ,
Not all .jurisdictions accept credit ands. please call, jurisdiction for more information. Permit fee j- c'D
0 Visa q MasletCard Notice: This pemtit application Minimum fee S
Credit card number: _ —__,, „ — _ / / expires if a pemtit is not Obtained Plan review (at %) c
Expires within 180 days after it has been State surcharge (8 %) .... $ ` G —
Name of rsrdhotder as shown on credit card accepted as complete. 'TOTAL 1 /� �' (�
Cardholder signature Amount }
440 -4611 (600 /COM)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION w ` Business Line: 03) 639 - 4171 MST
BUP
Received Date Requested / AM PM BUP
Location / .SO cZ ? " Suite EC LAS" °'O /
Contact Person Ph ) '7 ? y 3a g( PLM
Contractor P ) SWR �,,
BUILDING Tenant/Owner ELC k- '" / ‘"Q
�
Footing
Foundation ELC
Ftg Drain Access: . (.1 .-f_ n.G /1_1,44, 5`r ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear 1 /1 n L � �� 41/1/(-j �Z
Framing V " Y (7 f (J
Insulation Or.
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
PAS *ART FAIL
M\,, 'AL
Post : Beam p �
Rough-In
Gas
a Line � V "
Smoke Dampers
PART FAIL
E CTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 111 Please call for reinspection RE: i ❑ Unable to inspect — no access
Fire Supply Line ' V ADA a � ` Ins a ctor _ - Ext
Approach/Sidewalk / P =-
PP Date
Other:
Final DO NOT REMOVE this inspection rec d m the job site.
PASS PART FAIL