Permit J
C ITY OF TIGARD MECHANICAL PERMIT
4-44 I , DEVELOPMENT SERVICES PERMIT #: MEC2002 -00138
-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/8/02
PARCEL: 1 S135CD -03900
SITE ADDRESS: 11909 SW 95TH AVE 2
SUBDIVISION: BOETCHERS ADDITION ZONING: R -4.5
BLOCK: LOT: 008 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 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: Replace gas furnace.
Owner: FEES
HOUSING AUTHORITY OF Type By Date Amount Receipt
WASHINGTON COUNTY PRMT CTR 4/8/02 $72.50 2720020000
111 NE LINCOLN ST #200 -L 5PCT CTR 4/8/02 $5.80 2720020000
HILLSBORO, OR 97124
Total $78.30
Phone:
Contractor:
SPECIALTY HEATING & COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS
Heating Unt lnsp
Phone: 620 -5643 Final Inspection
Reg #: LIC 66578
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 otifroaton Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 001 -0080. You may •btain copies of these rules or direct questions to OUNC by calling
«n. 124R-0114Q
Iss By: _ - �
\ �_,��_L j Permittee Signature: r ��
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Flpr• 03 02 02: 18p Specialty Heating 503 598 071 8 p . 1
Mechanical Permit • A pp_ tion
Date received: k G'� Permit no.:ffQ �SOCA -ail /3
Aril 111' City of Tia . +r '
b Ptoject/appl- no.: Expire date:
City i > Address: I3125 SW : : . , Tigard, OR 97223
r o f b ard Phone: (503) 639 -4171 4,A) Date issued: IIy J Re ceipt nu.:
Fax: (503) 598 - 1960 ;\ `- SAL1 � 0 Case file n0.: Payment type:
B permit no -:
Land use approval; C;01.014.‘ ,.. -...
TYPE OF PERMIT , 11111111
26 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant impro' ement
Q New construction ■ Addition/alteration/replacement U Other:
JOB MTh INFORMATION COMMERCIAL VALUATION SCH 'MGM
. Job address: I L 7 S to 9:5 - .2- Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no_: 1 Suite no.: value of all mechanical materials, equipment, labor, overhead.
Tax map /tax lot/account no.: profit- Valud $ .
Lot: 1131ock: J Subdivision: 'See checklist for important application information and
Project name: (AMC-- p jurisdiction's fee schedule for residential permit fee
City/county: j`li►4 J' / ta__5fi. • ZIP: C/za -�-� 1 & 2 FAMILY DWELLING PERMIT FEE S ifEDULE
Description and location of work on premises: l(/.{ s�e-P 96 t COMMERICAUINDUSTRLAL EQUIPM • SCHEDULE
, .1.(/i!Y! lCt Z'' Fei (ea.) Total
F a . date of completion/inspection: MVO De rit'tion Qty. Re:only 114... onl'
•
Tenant improvement or change of use: 11VAC:
Air handling unit CFM
Is existing space heated or condition& Yes 0 No Air conditioning (site plan required) _ W
Is existing space insulated'es 0 No • Alteration of existing 1-VAC system MECHANICAL CONTRACTOR . oiler compressors
• E f �� 7 State boiler permit no.:
Business riamec� -� « �„ �� �ll� �G HP Tons IITU /Id
Address: Q S t i.) _f a7 f S r FirvJsrnoke dampers/duct smokr derer-tnre
4 City: lip).,./1 cif State: C,e._ ZIP: q 7a a 3 eat pump (site plan required)
- Install/replace fumace/burner BTU /H
Phone f�,�D� J S� Fax59�f °O �/ E - Including ductwork/vent liner D Yes 0 No I _ _
CCB no - _ 7 d' tnstalureplacc/rclocate heaters - suspended,
City /metro lic. no.: / . - wall, or floor mounted
Name (please print): • s rIto ,. ' 1'14 €.1-5 Vent for appliance other than f urnace
CONTACT PERSON Refrigeration: - -
Absorption units BTti/H , ,-
Name: /:}.TV Lee N ..SI<Lyi . q e f2 Chillers HP
-5-,a. $ Sc .c)'f�,, d S Compressors R P
Address:
9 ` Entirvarurutal exhaust and ventilation:
City: - 4, e i State:G2. ZIP: q ?0 -2--3 Appliance vent _
Phone6c,3 Gao -56 Fax: 5959-Cr/l? E-mail: Dryer exhaust - _
Hoods, Type - 9 Hires. ldtchcn/hazrnat
hood the suppression system --
Name: OM c ` ((! e/ Cl . A Exhaust fan with single duct (bath fans) _
Mailing address: / / 1._/ A(/LC/L.it/ Sr' Exhaust system apart from heating or AC
ZIP: 4 /aZ Fuel piping aua distribution (up to 4 outlets)
City: /fs ld State: _ . Type: LPG NG _ Oil
Phone: i ea,-q7 4/1 Fax: E -mail: Fuel piping each additional over 4 outlets
ENGINEER ' ocess piping (schematic required)
Number of outlets
Name: Other l appliance or equipment:
Address: Decorative fireplace ,
City: I State: I ZIP: - Insert - type ...,........
Phone: [ ax: J E -mail- Woodstovclpellet stove _ - --
Other;
Applicant's sign: ure: / //�. pgA.e i_Date: ,q /3/ 2 — Other:
t ]
Name (print): i E ;, ( • c -
No t jurisdiction., accept credit cam pilaw call pila call jurisdiction for more information. Permit fee $ - —
Vsa Notice: This permit application Minimum fee
expire if a permit is not obtained ,
Credit card num , within 18 da s after it has been Ilan review At _ %) $ .. _
i d C no „ ,� 1.� expi`ts w days State surcharge (8%) -_.. $ . .
p, Nngte of L s show cr�t
n oil t card accepted as complete, TOTAL $ -
■ ardholdcr signature A.nount , 410 -s417 (6r00/c0m)
•
CITY OF TIGARD j 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 _ MST
BUP
Received Date Requested C AM PM BUP
Location I i O q S W c `A4 Seri' a Suite MEC
Contact Person '(`(>\ ` \ Ph (Z_) 84 v- 4 19 1 4 PLM
Contractor -5 P r Qi1 Lrt\J 0% (7c:1.0 SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: IT
Post & Beam L L
ExtSreah /Sh R RL~2L 64,S V v\ R � v
Ext Sheath/Shear 'W'
Int Sheath/Shear
Framing
Insulation
Drywall Nailing -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling dk
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
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
tr osik k
PART FAIL
EL TRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before spection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: _ El Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date 3 6 Z Inspector �� Ext
Other:
Final DO NOT REMOVE this inspe • on ecord from the job site.
PASS PART FAIL
CITY OF *I IGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVI §ION Business Line: (503) 639 -4171 .�tlfST
BUP
Received Date Requested AM PM,/,2.-o/ BUP
Location /19 9 9s >t % / ' Q Suite // l�ujE�� — 0 o/�k"
Contact Person -�> �1 �. --cam Ph ( ) F0 9 7 ' 1 PLM
Contractor / � Ph ( ) SWR
BUILDING Tenant/Owner L /"L S ELC
Footing G
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: 6 S SIT
Post & Beam
Shear Anchors _ a
Ext Sheath/Shear / w '
Int Sheath/Shear V V
Framing
Insulation
Drywall Nailing /// l
Fire Sp I / A- a ��. , `Q\✓ v\ S-
Fire Sprinkler " ✓ ✓✓
Fire Alarm C- S ■-/■
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
PASS T FAIL
CHA
Post & Beam
Rough -In
Gas Line
Smo - Dampers
arr.
410
PASS PART
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 LI Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
Approach/Sidewalk ‘L‘
Other:
Date 1/ ` Inspector Ext
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL