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Permit C ITY OF TIGARD MECHANICAL PERMIT j DEVELOPMENT SERVICES PERMIT #: MEC2003 -00701 1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/9/03 PARCEL: 2S111 DB -12500 SITE ADDRESS: 15285 SW 94TH AVE SUBDIVISION: SUMMERFIELD NO.12 ZONING: R -7 BLOCK: LOT: 652 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: 1 STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 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: Install furnace and other appliance vent. Owner: FEES CAMILLE THOMPSON Description Date Amount 15285 SW 94TH TIGARD, OR 97224 [MECH] Permit Fee 12/9/03 $72.50 [TAX] 8% State Surchar€ 12/9/03 $5.80 Phone: 503- 620 -4741 Total $78.30 Contractor: CLIMATE CONTROL INC 16500 SW 72ND AVE PORTLAND, OR 97224 REQUIRED INSPECTIONS Phone: 503-453-4822 Mechanical Insp Final Inspection Reg #: LIC 62196 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: Permittee Signature: Qom/ , ,G / }-770 Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Dec 08 03 11:45a climate control 503 968 7224 p. r Mechanical Permit Application OFFICE USE ONLY 1 City of Tigard Date received:/c2 9 d3 A Permit no.:/t( i 03 -, • 70/ City of Tigard n : Project/appl. no.: Expire date: Address: 13125,S.W Half B'1vd,�Tigard, OR 97223 Phone (5 ) 63. �4.171N 167' ` Date issued: By. t j u A Fax: ( 50 3 ') 598 -1960 Y• �� Receipt no.: : i Payment type: o'� Case file no. � r Land use 2 Building permit no.: tr �T TYPE OF PERI IT • 1 & 2 family dwellings e s y D Commercial /industrial il New construction 0 Addition /alteration /replacement D Multi-family 0 Other: D Tenant improvement JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE J6b address: (rj2�j g W • g , Bldg. no.: Indicate equipment quantities in boxes below. Indicate the dollar Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: prat. Value $ Lot: Block: Subdivision: # ' Project name: See checklist for important application information and See - Thove,115 c-A,-Q Jurisdiction's fee schedule for residential permit fee. City/county:- �,�� ZIP: c7 ?any. I ,' 2FAMILy DWELLING PERMIT FEE SCHEDULE Description and lo anon of work on premises: 1I 'Stz�E f •c'i,,.v vk r I vl A ND COA1A41 RiCAL /INDUSTRIAL EQi1IP1lIENTSCHEDULE Est. date of completion /inspection: 1 . - - 'S -03 Fee (ea.) Total Tenant improvement or change of use: Description Qty. Res, only Res. only H VAC: Is existing space healed or conditioned? 0 Yes ❑ No Air handling unit CFM Is existing space insulated? 0 Yes 0 No Air conditioning (site plan required) MECHANICAL CONTRACTOR Alteration of existing HVAC system -= Boiler /com pressors Business name: c I irvla,� fi �' State boiler permit no.: Address: 1.(.0t500 Stv `J�vtcJ� � HP Tons BTU /H ■ Fob - •te ZIP, �7a Fire /smoke dampers /duct smoke detectors City: City: Spa t.(53- `fsoa eat pump (site plan required) -- - Fax: 'R - � . Install /replace furnace/burner • BTU /H CCB no.: t - 0 � 19. Includ;ng ductwork/vont liner '74 Yes CI No + IL. c I °O City/metro tic. no.: I LI l` Install / rep ace /relocate heaters - suspended, Name (please print): !l✓ ✓1 L (�y wall, or floor mounted t Vent thr appliance other than furnace CONTACT PERSON Refrigeration: to- Absorption units BTU /H Address: Chil HP Compressors HP City: Environmental exhaust and ventilation: State: 116111 Phone: Appliance vent I= Fax: E -mail: Dryer exhaust • OWNER ' Hoods, Type 1/ II /res. kitchen /hazmat Name: C� i (� TV-10 t'1t 5 hood fire suppression system Mailing address: It j Z Exhaust fan with single duct (bath fans) • S S� 9`0 - t- - 1 Exhaust system apart from heating or AC City: - 7 - -, ��� State:0 (Z ZIP: 9 '7 a.a. Fuel piping and distribution (up to 4 outlets) Phone: 5o� �1y Fax: E -mail: Type: _ LPG NG Oil ENGINEER Fuel piping sac additional over 4 outlets Proeess - piping (schematic required) Name: Number of outlets Address: Other isted appliance or equipment: City: Decorative fireplace State: ZIP: losers - type Phone: Fax: E-mail: Woodstove/pellet stove Applicant's signature: cQ Other: ' Name (print): , � � � i �"`" Date: I �- 75--0-3 Other: 61 l' I Not all jurisdictions accept credit cards. please call jurisdiction for more information. 0 Visa Q MasterCard Notice: This Permit um fee fee $ a(] . permit application Minim Credit card number: / expires if a permit is not obtained $ a- 'S Expires within 180 days after it has been Plan review (at %) $ Name of cardholder as shown on credit card State surcharge (8 %) .... $ _ 5. -6-0 accepted as complete. Cardholder signatuee $ TOTAL $ - 713 . 3c) Amount 440-4517 WOO /COM) • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (6D$)'639 -4171 MST 'j G Ar BUP Received / qi_� Date Requested b AM PM BUP Location Suite 3 O r Contact Person /) 'ie . �/ _ / Ph (_T ( 7S - 3 �P22PLM Contractor l L(,r�_ � -(7 ' l/t - '1- ---e- Ph ( ) SWR BUILDING Ten t/Own er ) a-444-4-62-e ELC N Gtk\-fi' Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam (;)/= A ' �1�t c --* Shear Anchors j /Ow1 Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing - Fi rewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam f Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin /Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line J J Smoke Dampers D CC- < n') v�.,� F a __ FAIL Service Rough -In UG /Slab Low Voltage (L-C Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA v Approach /Sidewalk Date v v Inspector ‘e■ Ext Other: Final DO NOT REMOVE this inspection record from the Job ite. PASS PART FAIL