Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2001 -00360
' µ'I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/12/01
PARCEL: 2S103CD -07500
SITE ADDRESS: 13750 SW 118TH CT
SUBDIVISION: CREEKSIDE PARK ZONING: R -4.5
BLOCK: LOT: 005 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Run gas line and install freestanding NG stove.
Owner: FEES
SCOLES, HARRY C + BARBARA Type By Date Amount Receipt
13750 SW 118TH CT PRMT CTR 10/12/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 10/12/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
T + K MECHANICAL
11525 SW CANYON
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Gas Line lnsp
Phone: 503 - 626 -4652 Heating Unt lnsp
Reg #: LIC 121165 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
rn1»aR_Q1 RQ
Issue By: oh- ' �/ Permittee Signature: �YL�
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit A i 1 *-'r on
Datereceived: ) Permit no.Mg j/ , BD3ZI0
lM k• ,
,,,� r .,I � — City of Tigard Project/appl. no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd, Tigati ; r ED
Phone: (503) 639-4171 Date issued: By:46 Receipt no.:
Fax: (503) 598 -1960 O` , i 2 20Q Case file no.: Payment type:
1 Land use approval: Building permit no.:
0 )....J.,.',. , .11 .t; ,
TYPE OF PERMIT
'-4 1 & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi - family ❑ Tenant improvement
0 New construction 0 Addition/alteration /replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: /3 '75i) 7. ) ) 1A 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 $ .
Lot: IBlock: I Subdivision: *See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: ii ta4 () r ZIP: 6/100 .- .. 1 & ZFAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: rlJ vl QS / j vi Slag/ AND COMMERICAL/INDUSTRIAL EQUIPMENTSCHEDULE
f e� A v‘att 11 cj N(l S,4v Fee(ea.) Total
Est. date of completiinspection: /t-) Description Qty. Res.only Res. only
Tenant improvement or change of use:
HVAC:
Is existing space heated or conditioned? ❑ Yes 0 No Air handling unit CFM
space insulated? ❑ Yes\ 0 No Air conditioning rati of existing plan HVAC system
Is existing P Alteration of existing HVAC system
MECH ANICAL CONTRACTOR Boiler /compressors
V State boiler permit no.:
Business name: � (' P , act -S pj 17�rf /J i ( �' HP Tons BTU /H
Address: //a) SL(...) C9 Y\ Fire /smokedampers/duct smoke detectors
City:l , U et -pv\ I State ) v- I ZIP: q7 Heat pump (site plan required)
Phone: 4Ik„ - 4 I Fax: t `/I % I E -mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner ❑ Yes ❑ No
' CCB no.: On CoS Install /replace/relocateheaters- suspended,
City /metro lic. no.: 4 g a t wall, or floor mounted
Name (please print): ' " (,U .� Vent for appliance other than furnace _^
CONTACT PERSON Refrigeration: __
Absorption units BTU /H
Name: 0 (.,f yttA ' t vl Z Chillers HP
' Address: i J (/a u ,, �,` Compressors HP
1 5 : ) s 5(--� Environmental exhaust and ventilation:
City: g'p I I ZIP: Q?ODS Appliance vent
Phone: (GG(o A(0SD- Fax: tad &,--( / j E -mail: Dryer exhaust
OWNER Hoods, Type 1/ tires. kitchen/hazmat
` ` hood fire suppression system
Name: Se G i,c 3 - (t ✓ .) a . v& _ Exhaust fan with single duct (bath fans)
system apart from heating or AC
Mailing address: /3/75c) f:3:-L) i �k J. Exhaust s y p g ,
City: 1 * a Statea.- I ZIP: 61-7r�-�
Fuel piping and dis (up to 4 outlets)
Goa` Type: LPG NG Oil tP.
Phone: 4 - 7 r : I Fax: I E -mail: Fuel piping each additional over 4 outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Other listed appliance or equipment:
Address: _ Decorative fireplace
City: n I State; I ZIP: Insert - type
Woodstove/ Iletstove
Phone: / Email: Other: r L'
�ff'l� E' ;1A v l't l i t 715 ; O' t )
Applicant's si • natur : A ` r WMFD L M i Other: 1 J _
Name (print):. ae AAA , ( Lvvi 7
t Permit fee $
'Not all jurisdictions accept credit cards, please call jurisdiction for more informatio
❑ visa ❑MasterCard Notice: This permit application Minimum fee $ 1 :� , SO
Credit card number: / / expires if a permit is not obtained Plan review (at %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ -�7 ( . -7
Name of cardholder as shown on credit card accepted as complete. ! TOTAL $ h 7t
Cardholder signature Amount 4 - 4617 (6/00/COM)
CITY - OF TIGARD BUILDING INSPECTION DIVISION r
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested /0 — 2 .5' AM PM BLD
Location 1 3 7 5U Suite MEC €/ DU 3
Contact Person Ph 3J 7 44, PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
CHA ALA.
eam
Rou In
Smoke Dampers
PAS PART FAIL
'ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date /0 — 2-5" Inspector ire Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
• rr
BUP - Building Permit ELC - Electrical Permit
-4 Inspection Description Date Passed By I Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing 4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry /Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing - 4 Inspection Description Date Passed By
Suspended ceiling Post /beam mechanical
Engineered soils Gas line /6 -zs- a i 4 ,
Welding Lab Final Mechanical rough -in
Concrete Lab Final Fire damper
Bolting Lab Final Duct work
Structural observation Smoke detector
Fireproofing Lab Final Mechanical final /6 -Z� 01 Ke
Final inspection
PLM - Plumbing Permit
BUP — Fire Protection System Permit -4 Inspection Description Date Passed By
Plumbing underslab
4 Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP/backflow preventer
Fire alarm final Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits
is \dsts \ forms \InspRecordBUP.doc 04/17/01
•
C ITY OF TIGARD MECHANICAL PERMIT
4�*�, DEVELOPMENT SERVICES PERMIT #: MEC2001 - 00360
'' _ - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/12/01
PARCEL: 2S103CD- 07500
SITE ADDRESS: 13750 SW 118TH CT
SUBDIVISION: CREEKSIDE PARK ZONING: R -4.5
BLOCK: LOT: 005 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Remarks: Run gas line and install freestanding NG stove.
Owner: FEES
SCOLES, HARRY C + BARBARA Type By Date Amount Receipt
13750 SW 118TH CT PRMT CTR 10/12/01 $72.50 2720010000
TIGARD, OR 97223 5PCT CTR 10/12/01 $5.80 2720010000
Total $78.30
Phone:
Contractor:
T + K MECHANICAL
11525 SW CANYON
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 626 -4652 Heating Unt Insp
Reg #: LIC 121165 Final Inspection
N
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. I
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 suspende
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregot
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
r'nw4 g1RQ
Issue By: `- _ ' �1 Permittee Signature: (�Y�
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day 114\