Permit 6 t '
CITY OF TIGARD
MECHANICAL PERMIT
a l Ai DEVELOPMENT SERVICES PERMIT #: MEC2001 - 00065
`- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 02/22/2001
PARCEL: 2S 110DB -91012
SITE ADDRESS: 15435 SW 114TH CT 101
SUBDIVISION: FOUNTAINS AT SUMMERFIELD ZONING: R -25
BLOCK: LOT: 101 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R1 VENTS W/O APPL: VENT SYSTEMS: 1
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: Install new gas fireplace insert.
Owner: FEES
SPYKER, ELINA TRUSTEE Type By Date Amount Receipt
SZALOBRYT, JANE C TRUSTEE PRMT CTR 02/22/20C $72.50 2720010000
15435 SW 114TH CT #101 5PCT CTR 02/22/20C $5.80 2720010000
TIGARD, OR 97224
Total $78.30
Phone: -
Contractor:
GEORGE MORLAN PLUMBING
9806 SW TIGARD
TIGARD, OR 97223 REQUIRED INSPECTIONS
Gas Line lnsp
Phone: 503 - 624 -6895 Mechanical lnsp
Reg #: LIC 2734 Final Inspection
PLM 26 -60p
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: '� P
C • 4 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day
41111
FEB -09 - 2001 15 01 r.el
10/1172000 UV:31 rtu JUJUOYi4ai , ..l t., vi 116u •
_
- A Mechanical Permit Application M ^ ,, .: } . �p,qp� , Idle received: J i O Pen:lit n0.: Ai we 1 W " , t (25
• City of I'lgard Project/app!. no Expire date:
City r¢rrdra Address: 13125 SW Hall Blvd, Tigard, OR 97213 Date issued: By Receipt no.:
Phone:
a x
Fax: (503) 598 9 -4171
F 1 O (n403 Z,
a: (503) 598 -1960 /� cue f to no.: Payment type
Building permit no.:
Land use approval:
.' I 2 family dwelling or accessory 0 Commercial/industrial 0 Multi family 0 Tenant imprnva cat
O New construction 0 Addition/alteration/replacement 0 Other:
,: JOB SI•I'E'INIORIUITION - ,: , .''' - ' - y , 7 , •, CO i•INirll(`I . I. V;%I,('A'1'i0N SCHEDULE
Job address: / 5 3 /L/ — . 1 O / Indicate equipment quantities in boxes below. indicate he dollar
Bldg. no.: 1 Suite no.: value of all mechanical materials, equipme t, labor, overhead,
Tax map /tax lot/account no.: profit Value $ _ •
`Sec checklist for important Lou Block Subdivision: 'Sec application information and
Project name: 1 arm,. 8 • • b,-- vi-
jurisdiction's fee schedule for residential permit fee.
Cry/county: ' • arm up: --/ • - S'` t ?MILT I)V* LUNG PFRM1IIT 11':1: y('11LU1'LL
Description and lot on of work on noises: � tr Oli� 4NDCOM11�11:1(11 11.11. 111 ;►.SI'k1+1L1OU1r111Cf1RSC11E0 'h1:;
/ nseF' c als tct . / 1 (1 .; rn4 ., Fee (ea.) Total
Est. date of complction/inspection: D •ou Qty. Rc .ostly Hes.only,
Tenant improvement or change of use; Air han
ir3ndlin); unit CAM
Is existing space beatod or conditioned? 0 Yes 0 No - Aireonditioning (rate pun r equired)
Is existing space insulated? O Yes Cl No Alteration of existing H V AI_ system
4 ' -' .MECHANIC.IL "' Boiler compressors
2 ♦ - , y State boiler permit no.:
Business name:
' ��I�a% 2 . /I HP Tons BTU1H
Address: or do ( �w Fire /s7ttokc datnpcsyduct smoke detectors
City: j / r a - is � c:01-1 ZIPg 7 Hcat pump (site plan required)
Phone: (,� -- /- 3 I Fax: ( -C C1I E -mail: tnstall/replaccfurnace/burner BTU /H
Including ductwork/vent liner O Yes O No
CCB no.: a 70 - tastallireplae a oc ruspendea
• City /metro lie. no.: 1 / (4 / wall. or floor mounted
1.misiminiiithatiitilaiiimmi Name (please prim): / 5 vent for ap Rance other then furnace
Refrigentwa:
Absorption units BTU /H
Name: Chillers HP _
Address: Compres:ors HP
r.nviruamental eschattst and veutllation:
City: I State: I ZIP: Appliance vent
Phone: Pax: Email: Trycrcxhntut
Hoods. Type UIl/res. larcheidhazmat
hood fire suppression system ,
Nome: / / ' ♦ • 0 Exhaust fan with tinf•le duct (bath fans)
Mailing address: .5' — 1` 0W • ., i • Faust system appart rTrm or AC
State: i Zp Fgel riving and (istributiao (up to 4 outlets)
ry — 0:90 r • 7 . _ Type LPG ,VG Oil
Phone: X. E-mail: FuelyipinE each addioonal over 4 outlets
. - FINGINll'It rrneesapsptag (schematic rrquirod) _
Number of outlets
Name: , Other tasted appliance or equipment_ '
Address: Decarnovefrc tact
_ City: I Stare: I ZIP: insert - type 9 /c-1 -1 r .
Phone: IPax: •I S -mail: WoodstoveIpolct
ocher
Applicant's signature: ! ,
(�'+IP: O her:
Name (print); i " ! '1 \/ /S a at _ '
$ 'lam
i iori+Qinieoc steep milt wadi, plow aia6a:w es
ear ma tntartnnda Permit fee
a, Notre: This permit application minimum f ee f
. t] Vwt O Maoerard C
expires if a permit is oat obtained plan review at s
96
�ledr are aoo>Oar / ( )
E, P;,® within ISO days after it fate boon statr, surcharge (8%) .... $ Smog of ocb,a+eec u r,o■ do c'od' cord accepted as complete_ T arr au $ ,
Csr eieuom Aef arii 440.6617 (6.00+CAlm
r -- TOTAL P.01