Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2001 - 00355
II DATE ISSUED: 10/11/01
13125 SW H all Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 114AB -03500
SITE ADDRESS: 16495 SW 93RD AVE
SUBDIVISION: KNEELAND ESTATES ZONING: R - 4.5
BLOCK: LOT: 022 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 2
Remarks: Installation of gas furnace and relocate gas line.
Owner: FEES
ALLERT, C WILLIAM + BEVERLY Type By Date Amount Receipt
16495 SW 93RD AVE PRMT CTR 10/11/01 $72.50 2720010000
TIGARD, OR 97224 5PCT CTR 10/11/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
SUNSET FUEL CO
PO BOX 42287
2944 SE POWELL BLVD REQUIRED INSPECTIONS
PORTLAND, OR 97242 Gas Line lnsp
Phone: 503 - 234 -0611 Mechanical lnsp
Reg #: LIC 00002374 Heating Unt Insp
ELE 26 -113C 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 -0010 through OAR
952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling
(1Y119dR -Q1 R� i
Issue By: _ / f , � JV Permittee Signature: c)77 ai2 /,(T2—
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
1el-08 -200 7:58AM FROM SUNSET FUEL 234 0439 P -1
- t.;
•
- - Mechanical•PermitAppllcatio
Date received: ( p 0 permit no..
,ce City of Tigard RECEIVED r f � ProjectFappl.no.: Expire date: G I -00.3 •
City of T igard Address: 13125 SW Hall Blvd, Tigard, OR 9722
Phone: (503) 639-4171 Date issued: s e/ Receipt no.:
Fax: (503) 598 -1960 OCT 8 2001 Case file no.: Payment type:
Land use approval: COMMUNITY DF.VFI OPMFNI Building permit no.:
'1'�' OF 1'I : '
`1 1 & 2 family dwelling or accessory O Commercial/industrial U Multi- family • . CI Tenant•imprvvement
■ New construction Addition/alteration/replacement 0 Other:
JOB'.SIFF INFORMATION (OM' D R('I:1I, ' 1`A I A SClU DI LL
Job address: . * S , i- , 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.: prof t. Value $ •
Lot: Block: Subdivision: *See checklist for important application information and
Project name: ii k jurisdiction's fee schedule for residential permit fee.
City /county: A, _ 4
ERM 1 4l 2 FA 8111 ;Y DWELLING PERMIT FEE S('IIE :1)F'LF
Description and location of work on premises: may» u. , c. AND ( \l \IEItl.t 1,lI \I)l :SfR1.1I. I ;QI'll'tiII::N•I•scii Emit:
'
.-^�- Fee(ea.) Total
Est. date of completion/inspection: Desert • .1 MI Res.o. Res...
�
Tenant improvement or change of use: A
Air han dlin: unit CFM ��
Is existing space heated or conditioned? 0 Yes O No Air con • Montag (site plan regpa
Is existing space insulated? 0 Yes 0 No Alteration o - existing A system = �
M}('II:1 \I(" ('O\ :oiler compressors
Business name: 5 w S c_ , . State boiler permit no.: ■
Address: . _ ` k
IIP • Tons BTU/1
u smoke dam . rs/duct smoke. detectors gm
City: 1).. \.� ZIP: ∎: Z3.v . Heat pum. site p an required) _ --
Phone: �'3L1. O t , \ Fax: - a 31a- s E -mail: eats ► cp ace ma umcr 01 B H I
Including ductwork/vent liner ' Yes O No 11 • `10 I
CCB no_: . '3 -II- nsta 'rep ac a ocateheaters suspen• ed, III
City /metro lie. no.: aH 5 wall, or floor mounted
Name (please print): 3 eM Ill e ; s t _ A , I ent or a a , Arleen er than - ace i '
('ONT.1(l" PERSON T, n on
Absorption units BTU/H II
Name: chillers HP E
Address: Com.ressors
' HP M
City: State: ZIP: �' .n event 1111 1111
Phone: ust • • ten .r c • m
Appiiancevent
E -mail: arc _ mst
' OWN> R • - •.•s, . ' tc - .azmat MIME _ -
hood fire suppression system
Exhaust fan with sin: a duct (bath fans) MIN
k, : -, :..... - lb' H - gusts stem - .: ..m eann_ or • .. ME
Essmilmammmul . state: a 2 ZIP' Z a a P p - .. ' 1 T ": . n up to ou cts
Phone: b� - 69 09 a :: E-mail: LPG _ NG Oil NINE 5 ,,,to
•i.in: ear. a• Om over • ou eta ��
><`:1(:1N1;:1:1Z - . • - , . X
. • ematicrequ - a) --
Name: Number of outlets _- MEI
-
Address: i'7, . i,..• a... os .,, :
Decorative fireplace M - ?
City: - State: ZIP:. nsert -type Mme=
Phone: Fax E-mail: °• I. • • tov stove ��
Applicant's signature: - Date: rt. �= M1 • Name atint): . 1111111.0..
Al a a�.s �+n bin � an - Permit fee S a .SY? ';r ? •�:, ,
U Notice: This permit application. �:
visa 0 R9 " j O,3 Minim fee. $ _ 1 a -;? �`; �.'�
Clod amber • - = ;+ 4_ ' 1 S ! e i f A permit is not obtained plan ' '' ° 1 . 7 , :
4 . • within 180 days atter it has been gsrt�+ review (At 96 S
_ � 1 State stucharge (1;96) .... $ • C> h` °�.
l'+ 1 7'ii� - $ accepted as complete.
TOTAL $ ' .3 n
•
ME fir":1.. —. ... � .- � ••� ' sas617 (tiva�VOM)
/n 2' /a -
•
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour InspectiGn Line: 639 -4175 Business Line: 639 -4171
/ BUP
D ate Requested l o — 2 _ 4 AM PM BLD
Location ""34,-/ , Suite MEC 2 b l 0 3S3
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/ ' LA - ELC
Retaining Wall , L IMMO ELR
Footing
Foundation FPS
Ftg Drain
Crawl Drain Inspe tion Notes: SGN
Slab SIT
Post & Beam /
Ext Sheath /Shear by D U % -• / i '
Int Sheath /Shear
Framing % - «I. _ Y /'•= a A - 3 p i .0 5
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART .FAIL
PLUMBING.
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PAS.S__PART FAIL
�MECHANICAL�_.
Post & Beam
Rough In
Gas Line
_woke Dampers
(� �RT — FAIL
LECTRICAL
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 // — �G -- 0/ Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site. •