Permit CITY TIGARD MECHANICAL PERMIT
0 DEVELOPMENT SERVICES PERMIT #: MEC2003 -00596
+ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/13/03
PARCEL: 2S1 10 D B -90371
SITE ADDRESS: 15485 SW 114TH CT 37
SUBDIVISION: FOUNTAINS AT SUMMERFIELD CONDO ZONING: R -25
BLOCK: LOT: 037 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Gas fireplace insert
Owner: FEES
KINCAID, JUANITA Description Date Amount
9850 SW HAWTHORNE LANE
PORTLAND, OR 97225 [MECH] Permit Fee 10/13/03 $72.50
[TAX] 8% StateTax 10/13/03 $5.80
Phone: 503 292 - 3648 Total $78.30
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 - 557 - 2220 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 -00
Issued By: I V Permittee Signature: I { •%, _ f „ �
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the ne t b siness day
Oct 13 63 O1 26p p -1
e __
M e c hanical PermitApplication O1 ►1(1 t 1
Date received: Permit
no. � . to _ r S .
��, , City of Tigard Projecr/appL no.: Expire date:
C � a j Tigard
Address: 13125 SW Hall Blvd, Tigard, OR 97223
Phone: (503) 639-4171 Date issued: By: Receipt no.:
Fax: (503) 598 -1960 Case tile no.: Payment type:
Land use approval: Building permit no.:
11 P1•. 01 P1.11%11 I
1.1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family 0 Tenant improvement
O New construction iltl Addition/alteration/replacement ❑ Other
.108 SI I E I \FOR11.1,1 ION CO1111I•.R1 1 11. 1 11.1 11 ION ti(ItE I)1 LE
Job address: /S j'B Sefo !« — (f 4 -3 7 Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value S
Lot: Block: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county 1- . a [ZIP: ry7 yZ c-f I £ Z 1'1111E1 n11 h :L1.1\(. PFR111 T FEE SC111111 I.F.
Description and location of work on premises: - I\i) comNi RIC 11.IINDI Still U. 1:Q1 1 P%IF . T »ClI FD1'I.F
6 cp-, -C. t jD l.�w 4 1 Yt a'i 60,:.. -Lilt z t et j 11 Fee (ea.) Total
Est. date of completion/inspection: Description Qty. Res. Only Rm. Only
Tenant improvement or change of use: HVAC:
Air handling unit CFM
Is existing space heated or conditioned? 13 Yes 0 No Air conditioning (site plan required)
Is existing space insulated? a'Yes Q No Alteration of ousting HVAC system
NIICII\5IC11. C(1 \I:R :1CIOR Boiler /compressors
State boiler permit no.:
Business name: Tri County Temp cgntrpl HP Tons BTU /F1
Address: 1 31 50 S. Clackamas R yer Dr_ Fire/smokc dampetslduct smoke detectors l ,
City: Oregon City I State: nR I ZIP: 97n d r Feat pump (site plan required) I ,
Phone: 557-222Q I Fax: 5 5 ZO q 1 E-mail: 6 InstalUreplace turnacerburner BTL 1
including ductwork /vent liner 0 Yes 0 No
CCB no.: 7 ln stai /rcpiacurelocate heaters — suspended,
City /metro lic. no.: 1 126 wall, or floor mounted •
Name ( please print): Giesele Saha. o n Vent for appliance other than hunace .
CON INC I PERSON Absorption Absorption "units BTU /H )
Name: Giesele Sahagon - Chillers HP
Compressors HP
Address: Same As Above Environmental e xhaust a nd ventilations
City: I State: I ZIP: Appliance vent
Phone: 557-2220 1 FaxS 5 7 0 9 1 9 E -mail: Dryer exhaust
011 \ER Hoods. Type U 11 /res. krtchcnvhazmat
hood fire suppression system
Name: 1‹.‘ Cra h — I Exhaust fan with sin • lc duct (bath fans(
Mailing address: 9'� -S - CD . :.t: %-I qe N `. r vt • Exhaust system apart from heatin . or AC �
p � , � Fuel piping and distribution (up to 4 outlets) ■
City: ! State: I ZIP: 97ZLs` • Type: LPG NG O i l
Phone: 9Z. — V; Fax: I E-mail: uel .1 r mg each ad tuonal over 4 out cis
ENGINEER Process piping (schematic required) =MN.
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace I 4- P‘
City: ' . State: ZIP: Insert — '
• Phone: ail: oodstovespellet stove l
Other: f
Applicant's signature 1 . , E � _ Date: 4 / f/ E 0 - 3 ether,
Name (print): - e —
0444 - r
ot
Permit fee ................... S 1 11(..) Na a ll nrudicmm arena credit coda. phrase call jf embeme for more tnformama Notice: This permit application Minim fee ...._.._._.. S
r visa ❑ CttastetCstd expires if a permit is not obtained Plan review (at _ %) S
Credit
camber . Ex within 180 days after it has been
State surcharge (8 %) .. S �� ` ��
;lame of eardhohda as as e card rd accepted as complete. TOTAL ..-.-- ....... -...-. S �-1 1 %.. + _
S
Cardholder nts.awe Amorea 440 -4617 (6001 Ct7U)
CITY OF TIGA4313 24 -Hour
BUILDING Inspection Lire: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
At"*
Vital BUP
Received Date Requested / I - AM r PM BUP
Location r S9 KS MEC 0 57k
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 4111 ,LA`4f • _ _ . _ �_ _ ELC
Footing � ELC
Foundation Acce - --
Ftg Drain r ` ELR
Crawl Drain
Slab In pection Notes: 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:
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
IUP 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: 111 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date if 3 - ''.3 Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL