Permit .
CITY TIGARD MECHANICAL PERMIT
{Ifs DEVELOPMENT SERVICES PERMIT #: MEC2000 -00421
{I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/25/2000
PARCEL: 2S 116AD -29900
SITE ADDRESS: 16880 SW 126TH AVE
SUBDIVISION: KING CITY NO. 10 ZONING:
BLOCK: 13 LOT: OOA JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMM. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Swimming Pool Heater
Owner: FEES
KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt
15245 SW 116TH PRMT JMT 10/25/20C $72.50 KING CITY
KING CITY, OR 97223 5PCT JMT 10/25/20C $5.80 KING CITY
Total $78.30
Phone:
Contractor:
MILWAUKIE HEATING + COOLING
9961A HWY 212
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 557 -5562 Final Inspection
Reg #: LIC 104102
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: Permittee Signature: - 77)a./
Call (5 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day
OCT 1940 THU 10:31 AM City of King City FAX:503 639 3771 PAGE 2
TRI-COUNTY
E
SERYi RYi(F( CENTER NTFII Mechanical Permit Application OFFICE USE ONLY
City of King City Datereceivod 10 .11,0o Pciril�i io_: % -. - ' .
w. yr 13125 SW Hall Blvd. ,+ Project/appl. no.: Expire date:
Clackamas Tigard OR 97223 I ( Date issued: r - ; By: Receipt no.:
Multnomah Phone: (503) 639-4 171, FAX: (503) 684-7297 Case file no.: Payment type:
Washington Building ^W�+ —
eouNrtes Land use approval: gpe rmit no.:
TYPE OF PERMIT
❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial 0 Multi-family 0Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: /6 egf) ,S / t 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 $
Lot: 'Block: Subdivision: - {See checklist for important appliaition information and
Project name: K t tO5 l ;i a - C .t u le - A r 0r. i 4*1 jurisdiction's fee schedule for residential permit fee.
City /county: l ZIP: 99 22..tj w 1 & 2FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: /2•,x. AND CO11MMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE
_— s. _ 1. • - - :4.w_.. •
,- __- Fee (ea..) Total
Est` date of completion/inspection: Description Qty. Res, ogly, Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? U Yes O No Air handling unit CFM
Air Condit al (site plan required)
Is existing space insulated? 0 Yes ❑ No Alteration of existing HVAC system
MECHANICAL CONTRACTOR Boiler /compressors
L State boiler permit no.:
Business name: ■ l 1 LW ' 1 RJ R. ■ C . ! is . 1 HP _ . Tons BTU/H
Address: OD - �t�tG - , ,•.9 i� ` Fire/smoke dampers/duct smoke detectors
City: In 1 /.c$3 Attic" 4 p` _ State 2j ZIP: �9 '.22 Heat pump (site plan required) _ -
Phone: / 3') 6-3-6„9 Fax:,�s')67),4 E -mail: Install/replace furnac urner B ! H
CCB no.: Including ductwork/vent liner O Yes O No
�� - _ _,_ . Install/replace/relocate heaters - suspended,
City /metro lic. no,: ,e3 �d 9 wall, or floor mounted
Name (please print): b ` e te "1 • *, ` Vent for app, ante other than furnace
CONTACT PERSON Refrigeration:
Absorption units B•U/H
Name: Chillers HP
Address; Compressors HP
City: State: ZIP: " Environmental exhaust and ventilation:
�. _._ Appliance vent _
Phone: Fax: E -mail: Dryer exhattsi
OWNER - Ioio s, - Type U IUres. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: State: ZIP: Fuel piping and distribution (up to 4 outlets)
Phone: Fax: E-mail: _ T LPG NG Oil
Fuel piping each additional over 4 outlets ,
ENGINEER •Yoce% piping (schematic required) - -
Name: Number of outlets •
Address: - -OOther listed appliance or equipment:
Decorative fireplace
City: l State: I ZIP: Insert -iiie .... _,,.. ..., .
Applicant's ax. (F -mail: Woodstove/pe(letetove _... ..._
ppcant's sgnature• Date: 1 s�6 Other.
.. _ -�. c!�/1�► l �,.,�,r/ f _....�. Other: VIOL.. xeP46C
Name (print): 3 p ' ,p5 _ r,
( Not all jurisdictions accept credit cards, please call jurisdiction for mire informatio Pe fee +�+
U v;, , q M t ccep to N otice_ This permit application Minimum fee $
expires if a permit is not obtained
Credit card number. / / Plan review (at %) $
-
Expire within 180 days after It has been State surcharge (8 %) $ 5 )
- —_ Name of cardholder as shown oa nvdit card accepted as complete. TOTAL $ 76.30
Cardholder signature Amo u nt
/40-4617 (/COM)
,
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested //'6 _ 4 AM PM BLD
Location f (o 0 6 0 5W (24 ,4 c `r /C - Suite MEC 2vu -&o 41.
Contact Person Ph 57 3 — 3s 7 -5 s ' Z PLM
Contractor // Ph SWR
BUILDING Tenant/Owner ,0-11 / i (( ELC
Retaining Wall G.. L G t,/C 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
FirewallAwd
Fire Sprinkler ice'' _
Fire Alarm
Susp'd Ceiling _
Roof
Misc:
Final
PASS PART FAIL
ot & Beam i' / /
Under Sllab �
,��� /�� � ) � /.9/ �
Top Out H4 445
Water Service )Zovi 4, // _..:.�:..... �%1 M � Fr _ ��
Sanitary Sewer
Rain Drains
Jl
FAIL U
A 7 AL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS 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 t 1
Other Date 1 I 6 6 Inspector er2D Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
MST — Master Permit
4 Inspection Description Date Passed By Notes
Grading
Footing /Setback
Foundation walls
Slab
Footing drain
Waterproof basement walls
Plumbing underslab
Crawl drain
Post/beam plumbing
Post/beam mechanical
Underfloor insulation
Post/beam structural
Shear walls /anchors
Exterior sheathing
Plumbing top -out
Gas line & test
Mechanical rough -in
Electrical rough -in
Electrical service
Low voltage
Sprinkler rough -in
Backflow preventer
Roof nailing
Firewall
Framing
MFG -Home set -up
Insulation
Drywall nailing
Masonry /Reinforcement
Rain drain
Sanitary sewer
Water service
Pump /fill septic tank
Approach /sidewalk
Grading final
Mechanical final )//,‘74 / 2
Plumbing final
Electrical final
Final inspection
Special Reports
SWR - Sewer Permit
Inspection Description Date Passed By Notes
Sanitary sewer
Final inspection
INSPECTION RECORD - MST (MASTER) PERMITS
CITY TIGARD MECHANICAL PERMIT
dl DEVELOPMENT SERVICES PERMIT #: MEC2000 -00421
" ' I I I 13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/25/2000
PARCEL: 2S 116AD -29900
SITE ADDRESS: 16880 SW 126TH AVE
SUBDIVISION: KING CITY NO. 10 ZONING:
BLOCK: 13 LOT: OOA JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 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: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Swimming Pool Heater
Owner: FEES
KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt
15245 SW 116TH PRMT JMT 10/25/20C $72.50 KING CITY
KING CITY, OR 97223 5PCT JMT 10/25/20C $5.80 KING CITY
Total $78.30
Phone:
Contractor:
CO
MILWAUKIE HEATING + COOLING
9961A HWY 212 r
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 557 -5562 Final Inspection
Reg #: LIC 104102
1
8
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 it 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: i, P a _ Permittee Signature: ?'7) ieG/
Call (5 3 639 -4175 by 7:00 P.M. for inspections needed the next business day