Permit CITY TIGARD MECHANICAL PERMIT
4 Ai 4, DEVELOPMENT SERVICES PERMIT #: MEC2003 -00501
l 131 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/15/03
PARCEL: 2 S 103C D -07100
SITE ADDRESS: 13890 SW 118TH CT
SUBDIVISION: CREEKSIDE PARK ZONING: R -4.5
BLOCK: LOT: 002 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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace furnace and install exterior A/C unit. Do not place within the required setbacks
Owner: FEES
GROVER, JERRY AND JUDY M Description Date Amount
13890 SW 118TH CT [MECH] Permit Fee 8/15/03 $72.50
TIGARD, OR 97223 [TAX] 8% StateTax 8/15/03 $5.80
Phone: 503 684 - 1809 Total $78.30
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006 REQUIRED INSPECTIONS
Phone: 503 848 - 3838 Final Inspection
Reg #: LIC 43124
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. / Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
08/15/2003 08:53 5033569002 GAROKEN a r D PAGE 01
* GEN
C
03 21 .'
. 01 WED 12:58 FAX b03 598 1960 CITY OF TIGARD AUG 15 2 °
z 0 04
I•ARD
Mechanical Permit.9 pplication
Batereceived: Permit no , .or, D
A u- - r City of Tigard Projcct/appl, no.: Expire date:
City of Tigard Address: 13125 SW Hail Blvd, Tiger1. OR 97223
Phone: (503) 639 -4171 Date issued: Receipt no •
Fax; (503) 598 -1960 Case file no.; Z; Pfyment type:
Land use approval: Building permit no.:
TYPE OF PER37I1
Biili & 2 family dwelling or accessory 0 Comm 0 Multi- family 0 Tenant improvement
0 New construction r - dditit n/alteration/replacement 0 Other:
JOB Si ii; INI ORMA'1 ION COMMERCIAL IAI. VAJ UA l ION SCIII Isu,.h;
' lob address:
- I - = 1k Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: Suite no.; value of all mechanical materials, equipment, labor, overhead.
Tax map /tax let/account no.: profit. Value $
( Lot: Block: Subdivision: *Sec checklist for important application information and -
Project name; ii r - , � jurisdiction's fee schedule for residential permit fee.
City /county; sin ZIP: � I & Z1-i1MIL)' DWELLING PERMIT Fla; SCHEDULE
. Description and 1 w- on of . ork on premises: ANI/ COMMERICAL /INDll.STRIAL EQUIPMElYI'SC11EDI1LE
ree(asa.) Total ,
Est. date of completion/inspection: Dosed �._ — 'C� • � Qty. Res, only Res. ottl■
Tenant improvement or change of use:
Is existing space heated or conditioned? 0 Ye; Are -�•
i=ttix7Tl'ttiTi'f (site p an require.) MEIN Is existing space insulated? 0 Yes No ++
�•�- cxtstrng • • system
- Boiler/compressors
Business name: - V State boiler permit no.: •
dress: S(o6 $w r$v� HP Tons
Ad
City: ft. I. - Art* • State: • 21[41 00 CO 'cat .ump s to . an require. ME • — ,
Phone 1 3$3
-S • s ; E — recta 'rep ace urnac bumcr - BTU
CCB no 43 Including ductwork/vent liner 0 Ye :4 o ral
11 5 5 nata rep ice/re ovate caters - suspen • e 111111 City /metro tic. no.; _ wall, Or floor mounted
Name (please print): , p a a T' i - Vent for appliance other than furnace
CONTACT PERSON
Refrigeration:
Absorption units BTU/I
•
Name: , CP VA.-v■ Chillers HP
Address: '�.;,� Com.resaora _ HP _ �
r ronmeota a ■oust an. yen at on;
City; State: ;IR Appliance vent
Phone: fax: E - mail: Dryer exhaust
Hoods, Type 1/ Hires. kitchen/harms(
Name: hood fire suppression system
Y • J ' f' Exhaust fan with Single duct (bath fans)
Mailing address; g !T - Exi aust eyalcm apart from njor AC -
M
' City: Mail State: ZIP: piping and distribution (up to 4 outlets)
Phon i'..�f�� a ` E -mail: T us : LPC} i NO Oil
us ptptnf each ad• Mona over . outlets
ENGINEER Process piping (schematic required)
Name: Number of outlets
Address: Outer listed appliance or equipment:
City: Decorative fire . lace
:.I ==
I Phone: Fax: E-mail.
"oo•stov pe let stove
Applicant's signal e: ���1�rr •
w /auk.. •• LI Date: i, II �
! Name (print): �° NO
' Noi :fl iuri.dcuons mew ucdii cards, please call j i sport ort inf umauon.‘ Permit fee $
; 0 visa t] M cad Notice: This permit application Minimum fee 5
Cfed;i card nuntxr: expires if a permit is not obtained -
° ,r � within 180 days after it has been Plan review (at %n) $
Nune or cardholder mown .i1 card accepted a complete. State surcharge (8%) ..., $ , ___
$ TOTAL S
holde sianesuse Am.'un1 --
463.1617 tbgp/CCm,
08/15/2003 08:53 5033569002 GAROKEN PAGE 02
(91IQ GAROKEN ENERGY DD. INC.
SINCE 1979
3566 Sw 192ND Ave • B[AvcRTON, OR 97007 • TEL 15031 1349-31338 • FAX (503) 356.9002
CCB# 431 24
$ //s /e
- Mgo ado R4 e±,
19c
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CITY OF TIGARD 24 -Hour
BUILDING Inspection Liner (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested AM PM BUP
Location / 3 .'d /l (VI L Suite 3 - QO SU (
Contact Person Ph ( ) PLM
G
Contractor Ph ( ) g d ` SWR
BUILDING Tenant/Owner ELT 3 - 0 65
Footing R' ( � _ 1 O 0
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain •
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation ry \,� r
Drywall Nailing r' �l' X- `= t
Firewall I D \J\ e App,/ Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof A ti Vki
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:
Anal
PA FAIL
ECH
eam �C 1
Rough -In
Gas Line
Sm. a Dampers
- T FAIL
ECTRI'
Seotipe
<194 - 41) � �� •
UG/Slab � j
Low Voltage �I V
Fir larm
Final Reinspection fee of $ required before next inspection. PART IL p 9 pection. Pay at City Hall, 13125 SW Hall Blvd.
SITE Please call for reinsp: ction RE: Li Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date / Q Inspe r _ Ext
Other:
Anal DO NOT REMOVE this inspection record from the jo site.
PASS PART FAIL