Permit CITY TIGARD MECHANICAL PERMIT
I ,a, DEVELOPMENT SERVICES PERMIT #: MEC2002 -00184
^ fl 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/6/02
PARCEL: 25111 BB -00300
SITE ADDRESS: 14085 SW 100TH AVE
SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -12
BLOCK: LOT: 011 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: 1
Remarks: Install gas furnace and 1 outlet.
Owner: FEES
PETERSEN, DAVE E + Type By Date Amount Receipt
DENA GALE PRMT CTR 5/6/02 $72.50 2720020000
14085 SW 100TH AVE 5PCT CTR 5/6/02 $5.80 2720020000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
PIONEER OIL
9270 NE GLISAN ST
PORTLAND, OR 97220 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 255 -0420 Mechanical Insp
Reg #: LIC 00057813 Heating Unt Insp
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 (503)246 -9189.
Issue By: w"`_. Permittee Signature: T! ( -?fe
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
APR -30 -2002 08:38 PIONEER OIL 503 255 0420 P.02/03
Meth uiiralPermitA,ppli ' n'
,. A _ C� Dare [r�eived: s /� z Pem,ic no. r; .tom - a od
J .i_�1 ` City o Tigard ,t1 Project/appL no.: &pi:e, date:
Goo/Tigard Address: '13125 SW Hall Blvd. Tigard, OR 97213 Date issued: Bye I Receipt no.:
Phone: (503) 639 -4171 ;PI �`
FaX (503) 598 -1960 Case file no.: Paymenitype:
Land use approval: Building permit no.;
TI 1'E OF PER NIIT
' I & 2 family dwelling or accessory Cl Commercial/industrial Cl Multi- family Cl Tenant improvement
■ New construction a Addition/alteation/topIacemcnt Cl Other: —
JOB SITE 1N! :OJl NATION CON iERCIAL % SCHEDULE
Job address: i $ s U.) i 1-1A 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 Bock: Subdivision: *See checklist for important application information and
Project name: ) j • °,- . u' -eM,., jurisdiction's fee schedule for residential permit fee.
City /county: -IETVXMII=EGLIE I & 2 FAMILY DWELLING I'ER11IT FEE SCHEDULE
Description and I. •, ■ % n of work on ■ i miser: _ AND COM1MMFRJC; LIINDUSTRIAL EQU1P1'1 ENT SCHEDULE
S A el # , , ✓ t 'e Fee(m) Total
Est. date of completion/inspection:
peseription MI Res,oul Res. may
Tenant improvement or change of use UYAC: ■ ��
Is existitng space heated or conditioned? Cl $-Ves No Mt-handling snit CM
Air existing space insulated? 13 Yes 0 No I te Iteration xi a • Ian req system rte
S P Itenuon o existing It C system
mEE't1,1N1(At; CONTRACTOR :•s - oilcp�sas II �
Business name; t' , , ., • t P State boilcrpetmitno.:
14P Tots BTU/11 Address: "' 1 A � i'irelamo • to - - duct smoke GetettOCS m � III
� I / ci:.: VA VP: ' Heat pump (sire .lan ragni - en) _
Phone: , - S' L 1 J -mail: mum • Alma - • timer - fit . • U'
CCB -_ �- �� Iaclttding ductwork/vent liner Yes O No
City /wean lie. no.: , O ■
Name (Please !►):
' entfor ancc other than enlace E -
.
('ON I A(•T I'I:RSON • A
Absorption units B'tLT/L�1
Name: tlti Ias_ — , HP — ��
Co ■ . HP iiM
Qty: State: 711: A ,ntteo.va us womanises ■ ��
• ' veer
Phone: Fax: Ismail: Myer cabalist Mil
OWNER 'oods,Type ► Os, Web . t NI __
hood fire suppression system
Name; 1= -e ae 2.1rge Exhaust fan with single duct (bath fans) - MEI
Mailing • 'r -- :1 OE I . . Et • tom a. infirm beam : or AC
City:'7 i . Sta Z q 722-3 e • r • . , r - *71 on up to outlets IIM
I. LPG NC Oil
Pho • " / ' ' +t Fax: Email: tape ad. • nal over 4 on eta w _ _
Cti(:INi:I:R
��MHO
Naraz: I . •, 1 , - or , , patent: • Address: iorativelxteplace
aty: • EMMII ZIP: inset- J. IIMIIIIIIMIIIMI
Phone: . _ pintail: woodsto . - stove NM
r s cr, M � —
Ap . Hellas signature: 7� 1 , Date P6 ]l A m.
Name (print): 11.: IV, ZIZErg -
' oL emit au5t cods, phew mtl iYrieSetlm lbr emit i d a tea Peonit fee .. --- $ 'Ia; 5 .
yc01 a Notice. This permit application Mitt fee._ $
JJ'`��
meth e
_•_.7 s If a dentin is tot obtained Plan review. (at %) $
d within 180 days titter it hw been Stara (8 %) - - -- $ _ O
mom ea .► i ` accepted as complete. TO'T11� $
e . 4e0400 nSteicono
CITY OF TIGARD 24 -Hour
BUILDING MD Inspection Line: (503) 639 -4175
INSPECTION DIVISION iv. Business Line: (503) 639 -4171 MST
J BUP
Received i Date Requested / ., -AM PM BUP
Location 1 g / T' — / ' ts Suite MEC -00 I g
Contact Person Ph ( ) PLM
Contractor Ph ( SWR
BUILDING Tenant/Owner `_ p ELC
Footing co0 — o Z �� ELC
Foundation Access:
Ftg Drain i C ELR
Crawl Drain
Slab Inspectio p «tes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof
Other: sr-
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 aff.J
- ou•h- ri
as Line
mo e Dampe
at
PART FAIL
ELECTRICAL
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 ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
L