Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2003 -00026
ry.� -" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/24/03
PARCEL: 1S135CD-03900
SITE ADDRESS: 11909 SW 95TH AVE 15
SUBDIVISION: BOETCHERS ADDITION ZONING: R -4.5
BLOCK: LOT: 008 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
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 furnace
Owner: FEES
HOUSING AUTHORITY OF Description Date Amount
WASHINGTON COUNTY
111 NE LINCOLN ST #200 -L [MECH] Permit Fee 1/24/03 $72.50
HILLSBORO, OR 97124 [TAX] 8% StateTax 1/24/03 $5.80
Phone: Total $78.30
Contractor:
SPECIALTY HEATING & COOLING
1601 SE RIVER RD
HILLSBORO, OR 97123 REQUIRED INSPECTIONS
Phone: 503 640 - 3607 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 Notification Center. Those rules are set forth in OAR 952 - 001 -00
r
Issued By: (�� ��_._ Permittee Signature: 414 4 01 of /
Call (503) 689 -4175 by 7:00 P.M. for inspections needed the next • si -ss day
Jan 22 03 11:27a Specialty Heating 503 598 0718 p.
r sw
i
i echanica1 P ion
Date received: Pe nod 033 Db° (o
' City of Tigard Project/appl.no.: Project/appl.no.: Expire date: `
City of Tigard
Address: 13125 SW Hall B1vd;nR t9R 4+'t � Datcissued: By. I Receipt in .:
Phone: (503) 6:19 -4171 CITY OF TIGARD
Fax: (503) 598 -1960 Lase file no.: _ Payment type:
BUILDING DIVISION Building permit no.: —
Land use approval: _
TYPE OF PERMIT
)l I & 2 family dwelling or accessory 0 Commercial/industrial Q Multi - family 0 Tenant improve went
0 New construction A Addition /alterationimplaccmcnt ❑ Other: _
JOB SITE INFORMATION COMMER 1AL VALUATION SCHED 1 LE
. Job address: //.77 ) 5 _ Indicate equipment quantities in boxes below. Iridicat: the dollar
Bldg- no.: Suite no.: value of all mechanical materials, equipment, labor, c vcrhead,
profit. Value $ , _
_ Tax map/tax lot/account no.:
Lot pluck: 7 Subdivision: *See checklist for important application information ind
d y [ ���� jurisdiction's fee schedule for residential permit fee.
Project name: �T. �r T' • � ' ��itiGfR� � • -- - - - City/county— J, "7 'ZIP - �;- —. — I & 2 FAMILY I WELLING PERMIT I? � S s IEDt'LT _...r
pest iption and location of work on premises: � • .1:'...,-.-_ _ - • AND COMMERIC: /INDUSTRIAL £QUIPME SCHEDULE
--W-z4/1 a C Fee ,ea.) Total
Description t . Res. only Res. only
_ Est date • om.leti ■ spection: / p 3 : VAC:
Tenant improvement or change of use: Air handling unit . CF1v1 -.
Is existing space heated or conditionedes ❑ No ,
Air conditioning (site plan required) _— _.
Is existing space insulated' .r Yes C i No Alteration of existing HV AC system
1 lEU 1ANICAL CONTRACTOR i oder compressors
State boiler permit no.:
Business name: .. .iAlt_ir imp 4e // • G Hp Tons BTU /H
Address: i ci/ S '�ii/Q RD ^ D - Fi smokedampers/duct , _
City: Ma+ n State: / ' ZIP: q ?/a+3 Heat pump (site plan rcqu
nst 1 replace furliac � utner TO :TUT
Phone: Fax: �p �f E Including ductwork /vent liner 202es C1 No _
CCB no.: . $78' , Instau/ replace /relocatcheaters suspended,
City /metro lic. no.:/ Q - i — wall, or floor mounted
Name (please print): Orin 0 - irk- Vent fora liance other than furnace
efngerxnon:
Absorption units BTU/14
Chillers HP W
Name: o (eQe N .S/� //Y/Y — Con" 'lessors HP
Address: X�t !U<.1�2 RO '1� — Environmental exhaust and ventilation:
City: // s "Ave) StateC ZIP:- 97/3--- Appliance vent . .
Phone: &A 3Go7 - Fax:lr /-D'Q3 E -mail: s ryere . st _
OWNER Hoods, Type 1/ Hires. kite en/hazmat
hood fire suppression system .
Name: tom!/ ✓ 'FIFO ea4.4 1 / Exhaust fan with single duct (bath fans)
Exhaust system apart t h or A
Mailing a dress• . / h •
"o ! " �E ✓N
.�ft� St ate T }rel pe. piping Rnd distribution (up to 4 outlets)
City: f�`T�� / St: D 7.lOP: 97/2 ' � �, NO Olt
Phone: 4 - y('f Fax: E - mail: Fuel piping each additional over 4 outlets
'Process piping (schematic required) ,
Number of outlets
-
Name: Other lisle tl applisince or equipment:
Address: . . • Decorative fireplace
-
State: ' ZIP: Insert- type ,
Phone: �Yoodstavelpeuetsauvc ..
Pho F B ttrail: 0i2aer
Applicant's signature: fratfo j Date: / /a•sl O ,--
Name (print): • ! !ir /N/Y' . - .�-
'Na ou ;uciadicliwts accept a iidit cards, please call jurwllctioa for mats infarmauun Permit fee $ . _ �'��a
Notice: This permit application minimum fee $
CI Visa
U MasterCard expires if a permit is not obtained Plan review (at _, %) $
Credit t number witn 180 d it has been
Expirrs hi s a State surcharge (8%) .... $
Name of cardholder as shown on credit card accepted as complete_ . S TOTAL `
` Cmmaordcr sigmtu,e Amount J 440.4617 (6e0l1/COt+'t)
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested � AM PM BUP
Location Suite / MEC d o v°
Contact Person Ph ( ) G ct o -34 6 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: F 2 SIT
Post & Beam o ✓O - /� -✓' 2 � ,
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final clIL.Arak i Ri
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
PAS PART FAIL
•EL TRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA � ()
Approach /Sidewalk
Date — ( 0 3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL