Permit CITY OF TIGARD
A i
MECHANICAL PERMIT
DEVELOPMENT SERVICES 9 �' PERMIT #: MEC2004 -00216
° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/26/2004
PARCEL: 2S110AD -03900
SITE ADDRESS: 14655 SW 106TH AVE
SUBDIVISION: LANG HILL ZONING: R -12
BLOCK: LOT: 033 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:
Remarks: Furnace installation.
Owner: FEES
BURKS, GILDA M + CHARLES C Description Date Amount
14655 SW 106TH AVE [MECH] Permit Fee 4/26/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 4/26/200 $5.80
Phone: 503 684 - 3119 Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 Heating Unt Insp
Final Inspection
Reg #: LIC 72623
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: (7)1 c744 ,c)-
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Apr 25 04 03:58p TriCount Temp Cntrol 5035570919 p.1
_ _
Mechanical Permit Application
City of Tigard RECEIVED Date / j/, /O� Permit m.: /nLZ g.yi_. p L � 4
.A _ Ptoject/appL no.: Expire dm:
—
City of Tigard Address: 13125. SW Hall Blvd, Tigard, OR 972'x. -3 Date � * " � B o) Receipt (503) 639 -4171 APR 2 6 2004
Fax: (503) 598 -1960 Case file no.: Payment times
Land use approval: CITY OF TIGARD Building permit no.: /r-/C
111'1 Of 1'[.I011I
l & 2 family dwelling or accessory O Commencial/iadustrial 0 Multi- family 0 Tenant improvement
0 New construction XAddiuon/alteratiooireplacement 0 Other:
.1011 *TI 1 E INF0101.1l 10N C0%1S1[:R( 1 ■Ll 11 IO\ ,(71EI11 I.E
Job address: 4t MA, l (Glil .4Vt , Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: j Suite no.: value of all mechanical materials, equipment, labor, cvencead.
Tax map /tax lot/account no.: profit Value S
Lar (Block: (Subdivision: 'Sax checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: j I.((S JZ`f I ZIP: i"11 I & 1 F 1MI11.1 1M E1.I.I\t. PFR%II r (FE S( 1IFUl 1.F.
Description and location of work on premises: f )r." ) NT' %NI) (1)%111FRI('11.INDI silt' 1L IP
+ Fee ea.) I Total
Eta. date of completion/inspection: Description Qtv.I Res only Res, only
Tenant improvement or change of use: HVAC: I I I
Air handling unit CFIN !
Is existing space heated or conditioned? 0 Yes 0 No Air conditioning (site plan required) I I
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system I I I
,IFCII% l('11. CON [RACIOlt Boller/compressors I I
State boiler permit no.:
Business name:
Tr C ounty Temp Control HP Tons BTUtli
Address: 1 31 50 S _ Clackamas R1',ver Dr _ Firetsmokc dampers/duct smoke detectors I I I
City: Oregon City i State: oR I ZIP: g 7 n 4 5 Heat pump tsne plan I I I
Phone: Fax: E -ma il: Install/replace tumacc burner "BT WH i( i
5 5 7 - 2 2 2 0 5 �7 021 Including ductwork/vent liner Yes 0 No I
V --
CCD no.: 7 2 6 2 3 InstalUreplacelrelocate heaters - suspenaca,
Ciry/metro lic. no.: 1 126 t wall, or floor mounted
Name (please pair) . na ( o?11i Vent for appliance other than furnace I 1 —
&efrsgendon: I I
Absorption units BTU/H
Name: Chillers HP
Compressors HP
Address: Same As Above
Eavitronrs oral exhaust and ventilation: i
City: I State: I ZIP: Appliance vent
Phone: 557-2220 Fax,`' 5 7 0 91 9 I E - mail: n Cr Cxlianat ■
Hoods, Type 1/ 11/res. kitchenrhazmat
hood fire suppression system
Name: � `t Cl1 Ida- LU h? Exhaust fan with sin • le duct (bath fans)
Mailing address: /4. 6P '01 If•( 1 •''f_ r xhaust system apart from heating or AC
City. ' ( q&r ! State: I ZIP: 4`
' fuel piping and distribution (up to eiders)
II Type: LPG NG Oil
Phone: L,(o`')` / Fax: (E-mail: Fuel piping each additional over 4 outlets
Process piping (schematic required)
Number of outlets
Name: Oiler listed appliance or equipment:
Address: Decorative fireplace
City: ( State: I ZIP: Insert - type .
Phone: I Fax: i E -mail: Woodstovelpeilet stove
Other
Applicant's signature ( Date: Ober:
Name (print): -
'.4 all prndicmm accept credit cede. please dl jerndicma for mole � deroaOOa Permit fee _ e . ... - S
M Visa 7 MasterCard Nodtx: This perm applitcttian Mi n i mum fee .. _ _ S
acprres if a permit is not obtained Plan review (at — %) 5
wait card eumty. Expire! within 180 days after it has been
State surcharge (8o/ , a) .... S },
Name of cardholder o stereo .. ad Greet card acet prod as complete.
S _ TOTAL ---- _- -_ -_ S l -J� � ,E) E (� y
Cardholder evacuee Aaomal R t,. v E V E .4 -4417 (603/0341
AN t 2004
CITY OF TIGARD
BUILDING DIVISION
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
c� BUP
Received Date Requested Li- / AM PM BUP
Location /6 , -U`- -- Suite MEC V•0 - ()&; f 7
Contact Person Ph ( ) S7 2-2-0 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: t ao ,3: OD SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler C r
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
11)
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 pampers
• • SS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage t L •
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
Date f' ' Ext
Approach/Sidewalk T Inspector `,,.
Other:
Final DO NOT REMOVE this inspection record fro the job /site.
PASS PART FAIL