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Permit CITY TIGARD MECHANICAL PERMIT PERMIT #: MEC2001 -00236 .0.14 DEVELOPMENT SERVICES DATE ISSUED: 6/27/01 q=-- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 104AA -02300 SITE ADDRESS: 12285 SW 127TH AVE SUBDIVISION: BELLWOOD ZONING: R -4.5 BLOCK: LOT: 072 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: 1 DOMES. INCIN: 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: > 10000 cfm: GAS OUTLETS: Remarks: Installation of exterior A/C unit. Unit cannot be placed in required setbacks. Owner: FEES GRANTHAM, TRACY ANN Type By Date Amount Receipt 12285 SW 127TH AVE PRMT CTR 6/27/01 $72.50 2720010000 TIGARD, OR 97223 5PCT CTR 6/27/01 $5.80 2720010000 Total $78.30 Phone: Contractor: COLUMBIA HEATING + COOLING INC PO BOX 230397 TIGARD, OR 97223 REQUIRED INSPECTIONS Mechanical Insp Phone: 624 -2704 Final Inspection Reg #: LIC 76359 PLM 34 -175 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 oft - - les or direct questions to OUNC by calling (503)246 -• • . Issue By: L =o „ �� Permittee Signature. Call (503) 639 -4175 by 7:00 P.M. for inspections needed the • . t bu Fess day Mechanical Permit Application A Date received: ' 7 7 e �' e �t�� 776...._ 2/ / / Permitno.: C2001- DU 231< t',.� i 1Y City of Tigard t ?7ZZ3 Projectlappl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard, OR Phone: (503) 639 -4171 Date issued: By4.9fir Receipt no.: Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: Building permit no.: TYPE OF PERMIT • 4 & 2 family dwelling or accessory CI Commercial/industrial U Multi- family ❑ Tenant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: 1 a a ' 5 ,e;oci / z 7__ 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: J Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: t c ZIP: ell ZZ 3 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of wor on premises: AND COMMERICAIJINDUSTRIAL EQUIPMF:NTSCIIF.DULE . ttlSkct1lCL -r G k iai Cc " „ Fee(ea.) Total Est. date of completion/inspection: >j t f :27 Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: • Is existing space heated or conditioned? O Yes Cl No Air handling unit _ CFM Air conditioning (site plan required) Is existing space insulated? U Yes Cl No Alteration of existing HVAC system MECHANICAL CONTR "IOU Boiler /compressors Business name: ( State boiler permit no.: • HP Tons BTU /H C t� on � , (� at �l v� � -I Address: C) r r ,,,..1 r vi hek Fire/smoke dampers /duct smoke detectors _ City: i' (,e., fd' I State: } ZIP: t% 7 �k3 Heat pump (site plan required) Phone: (, -77C'I {Fax: J E Install/replace furnace/burner BTU /H Including ductwork/vent liner ❑ Yes O No CCB no.: 7 (,;>5 j Install /replace /relocate heaters — suspended, City /metro lic. no.: / ' 7 ¢ wall, or floor mounted Name (please print): Vent for appliance other than furnace CONTACT PERSON Refrigeration: Absorption units BTU /H Name: ,r4 a j (i s(.1 i Chillers HP Address: Sc ,4_) &l j , y � Compressors HP City: d r State: / ` gyp: Environmental exhaust and ventilation: 7 3 Appliance vent Phone: i( - 27 C Fax: E -mail: Dryer exhaust Hoods, Type /res. kitchen/hazmat hood fire suppression system Name: I Irra C y C l{ if►a Exhaust fan with single duct (bath fans) Mailing address: j , � ra j S' 5 Sw I D 7 t'` Exhaust system apart from heating or AC Ci Fuel piping and distribution (up to 4 outlets) h T,' - 4 r d State: ZI / 7� �3 Type: LPG NG , _, Oil Phone; r ` F ax: E -mail: 'Fuel piping each additional over 4 outlets Process piping (schematic required) Name: Number of outlets Other listed appliance or equipment: Address: Decorative fireplace City: State: I ZIP: Insert — type Phone: Fax: E - mail: Woodstove/pellet Other: Applicant's signatur ,,, Date: \ 2 - -1 0 j — Biter: Name (print): 11-iry iln, rr- i 1r11(I 'Not all jurisdictions accept credit cards, please call jurisdiction for more information Permit fee $ 702 + .5 U ❑ Visa ❑ MasterCard Notice: This permit ap Minimum fee $ Credit card number / expires if a permit is not obtained Plan review (at %) $ Expires within 180 days after it has been State surcharge (8 %) .... $ , Fa Name of cardholder as shown on credit card accepted as complete. TOTAL $ 7eP . '3 Cardholder signature `Amount • 440.4617 (6 /00 /COM) Columbia Heating & Cooling, Inc. P.O. Box 230397 Tigard, OR 97223-0397 Phone: 503 -624 -2704 Fax: 503 - 598 -0270 4 6,.1Aki bl/J ti • CITY OF TIGARD BUILDING INSPECTION DIVISION • MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 (� BUP Date Requested ' ? �S AM PM J/ BLD Location / Z Zr3) 5 / Z 7 v-t Suite MEC 2,U° / Z3 .. Contact Person Ph G Z V 2- Z9 y 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 17 t 64,7 ," E u / /r. - u/ fair Insulation Drywall Nailing / C- Lim .'T Gc`/1y Uvt p/ Firewall Fire Sprinkler Fire Alarm r Susp'd Ceiling r SC Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL N t os eam Rough In Gas Line S ke D mpers G A PART 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 i �, J� / 8' �I Inspector Ext _S"CZ Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • BUP - Building Permit ELC - Electrical Permit sf Inspection Description Date Passed By 4 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 4 Inspection Description Date Passed By Drywall nailing Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Structural observation Mechanical final Fireproofing Lab Final /74- 1 -c)/ Final inspection PLM - Plumbing Permit BUP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab J 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 AI 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 "I 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 CITY TIGARD MECHANICAL PERMIT >r'� DEVELOPMENT SERVICES PERMIT #: MEC2001 -00236 'N 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/27/01 PARCEL: 2S1 04AA -02300 SITE ADDRESS: 12285 SW 127TH AVE SUBDIVISION: BELLWOOD ZONING: R -4.5 BLOCK: LOT: 072 JURISDICTION: TICS 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: 1 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: AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: > 10000 cfm: • Remarks: Installation of exterior A/C unit. Unit cannot be placed in required setbacks. Owner: FEES GRANTHAM, TRACY ANN Type By Date Amount Receipt 12285 SW 127TH AVE PRMT CTR 6/27/01 $72.50 272001000C TIGARD, OR 97223 5PCT CTR 6/27/01 $5.80 2720010000 Total $78.30 Phone: - Contractor: COLUMBIA HEATING + COOLING INC PO BOX 230397 TIGARD, OR 97223 REQUIRED INSPECTIONS Mechanical Insp Phone: 624 2704 Final Inspection Reg #: LIC 76359 PLM 34 -175 N 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 i 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 oft - - les or direct questions to OUNC by NI/ calling (503)246- • ; • . '.. Issue By: LI 4g„r. �� Permittee Signature. ' Call (503) 639 -4175 by 7:00 P.M. for inspections needed the - -'" bu Fess day