Permit CITY TIGARD ,I MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2002 -00304
' - • 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/18/02
PARCEL: 2S116AD -20200
SITE ADDRESS: 16815 SW 129TH AVE
SUBDIVISION: KING CITY NO. 18 ZONING:
BLOCK: 24 LOT: 001 JURISDICTION: KIN
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:
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: 1 GAS OUTLETS:
> 10000 cfm:
Remarks: (1) 1,200 cfm AHU & alteration to existing HVAC
Owner: FEES
KEEFER, J RAMON AND CLAIRE Type By Date Amount Receipt
16815 SW 129TH PRMT BB 7/18/02 $72.50 KING CITY
TIGARD, OR 97224 5PCT BB 7/18/02 $5.80 KING CITY
Total $78.30
Phone:
Contractor:
BELL HEATING
15550 SE PIAZZA AVE
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503 - 656 -1184 Final Inspection
Reg #: LIC 447
PLM 3 -286PB
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.
i / /
Issue By: j/, , � �� �, Permittee Signature: p5 c,g dk�](
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bu nes day /
TRI- COUNTY
.iRVICICEc Mechanical Permit Application • OFFICE USE ONLY
/e _ £ +� . Date received: Permit no.~
_, \ City of King City ,r Zc Z rd v�
13125 SW Hall Blvd. Project/appl. no.: Expire date:
� ` "°�
Tigard, OR 97223
ClackarnaS g Date issued: By: Receipt no.:
Phone: (503) 639 -4171
:Multnomah , FAX: (503) 684 -729 Case file no.: Payment type:
Washington
C O U N T I E S Land use approval: Building permit no.:
• , TYPE'OF PERMIT .
d l & 2 family dwelling or accessory 0 Commercial/industrial . 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration/replacement 0 Other:
.:.:: JOB SITE' INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: I (p ( 5 ,� (aa
P 4s • Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax ap tax lot/account no.: profit. Value $ .
Lot: Block 'Subdivision: *See checklist for important application information and
Project name: 1\ L.0 y jurisdiction's fee schedule for residential permit fee.
. City /county: `TtC•A2k ZIP: C t•7a , a � - °I &2FAMILY:DWELLING PERMIT FEE SCHED 7
Description and location of work on premises: AND • COAMIERICAL/INDUSI'RIAL EQUIPiMENTSCHED
Fee (ea.) Total
Est. date of completion/inspection: Description !Qty. Res. only Res. onh
. Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit (� (� U CFl�1
Is existing space insulated? 0 Yes 0 No Air conditioning (site plan required)
Alteration of existing HVAC system I
. ' ' .''y -1MECHAN ' - Boiler /compressors
;' .Business name: • bl 1--1T i'tJ�• State boiler permit no.:
v HP Tons BTU/H •
I � -�`� S
, Address: T
t. ZAZ P - ' C4 Fire/smoke dampers duct smoke detectors -
':City: C IP C, 17vV State�qi ZIP:
� I l RZo 1,'j Heat pump (site plan required)
;:Phone: G6C.•I -k I Fax:(5 E -mail: Install/replace furace/bumer BTU/H i
CCB no.: q Including ductwork/vent liner 0 Yes 0 No
Install/replace/relocate heaters — suspended,
'j
City /metro lic. no.: I (� AAA -ro
wall, or floor mounted
Name (please print): S•j /y Q5.1 \_5 Vent for appliance other than furnace
° r , ; 'CONTACT• PERSON - • • Refrigeration: •
Absorption units BTU/H
Name: g -. ` .•/∎ -% Chillers HP
Address: Compressors HP
Environmental exhaust and ventilation:
City: D e>. State: ZIP: Appliance vent
Phone: G' (L ' I ($ Li ( Fax I E - mail: Dryer exhaust
i • _ . k.': •_ at ` Di... •. • Hoods, Type U lures. kitchen/haanat
hood fire suppression system
Name: 1l.,_ L fan with single duct (bath fans)
Mailing address: I t ( �� \ C J (9'T AU Exhaust system apart from heating or AC
•
City: ( r1Gcj',{ -1- d State: or ZIP: to ') ), a vl Fuel piping and d (up to 1 outlets/
-/ G Type: LPG NG Oil
Phone: J ax: I E -mail: Fuel ei.ing each additional over 4 outlets I
;'` .. : ir _ ;.`: ENGINEER, ,, . _ -, ' Process piping _ p p g (schematic required) I I
;Name: \ Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: Stae: ZIP: Insert — type
Phone: i Fa. f E - mail: Woodstove /pellet stove
Applicant's signature: (\/-- Date: Ocher.
Name (print): . Other:
Sir k i
Not
all lurisdicuons accept credit cads. please call jurisdiction for more information, Permit fee $
J Visa 0 MasterCard / Notice: This permit applicatio Minimum fee $
e xpires if a permit is not obtained �
": a1�t card number: � / Plan review (at %) $
Expires within 180 days after a has been
State surcharge (8%) $
Name of cardholder as shown oa credit card accepted as complete.
S TOTAL $
Cardholder signature Amount
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested / - 2' AM PM BUP
Location lb ,/ ( 5 4 // 2 % /C C Suite MEC v Z - 6v 3G ((
Contact Person Ph ( ) 4f4 Pal X z/ PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
•
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall / 7
Fire Sprinkler 7.--"":7
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
IIECHAIVN.
Post & Beam
Rough -In
Gas Line
oke Dampers
Final gm (- firm)
AS PART FAIL
TRICAL
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 Ei Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA •
Approach/Sidewalk Date _ 1 Spector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL