Permit `h n
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2001 -00279
` DATE ISSUED: 08/03/2001
- - 13 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S110DB -90962
SITE ADDRESS: 15437 SW 114TH CT 96
SUBDIVISION: FOUNTAINS AT SUMMERFIELD CONDO ZONING: R -25
BLOCK: LOT: 096 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: 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:
Remarks: Installation of gas insert. (gas already in place.)
Owner: FEES
TOM & JOAN RYAN Type By Date Amount Receipt
15437 SW 114TH PRMT CTR 08/03/20C $72.50 2720010000
#96 5PCT CTR 08/03/20C $5.80 2720010000
TIGARD, OR 97224
Total $78.30
Phone: 503 - 624 -6784
Contractor:
T + K MECHANICAL
11525 SW CANYON
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503 - 626 -4652 Final Inspection
Reg #: LIC 121165
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 -9 b'.
Issue By: Lam' . A ," Permittee Signature: p Q� ��
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Ap 5 'o
A Date receive : ?� D 1 Permit no.:M 00/.06.1.7?
w. ,t,r, Cit of Tigard �`:_,. y g Project/appl. no.: Expire date:
City of Tigard • Address: 13125 SW Hall Blvd, "l c' lJ 23
Date issued: By: b(/�J Receipt no.:
Phone: (503) 639 -4171 YY
Fax: (503) 598 -1960 A!! G _® q Case file no.: Paymenftype:
Land use approval: d Building permit no.:
1;,rltcat i i P .141' ii
TYPE OF PERMIT
)(1 & 2 family dwelling or accessory 0 CommerciaUindustrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other:
' JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
Job address: i 5'513,7 // ou . 9,7 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 $ .
t - Lot: C I Block: Subdivision: -. - - *See cheeklisf` for - important application'itiformation and '
Project name- jurisdiction's fee schedule for residential permit fee.
City / county: qa vf j i ZIP: q 670 ..1 &'FAMILY DWELLING
WELLING`PIERMIT FEE SCHEDULE
Description and #cation of work n premises: ` . i 11 • ez ■ AND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE
h I letion / ins ection: U (t p /a C p l /Sk 2_. i Fee(ea.) Total
Es .date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM
space insulated? O Yes ❑ No Air conditioning (site plan required)
Is existing P Alteration of existing HVAC system
• MECHANICAL CONTRACTOR Boiler /compressors
State boiler permit no.: -
j
Business name: i- K kecWtntn ( a _ , r4yp pkze�
q � HP Tons BTU /H
Address: / /50.,S' SCD l CulA_ .O Fire/smoke dampers /duct smoke detectors
City: gp U I Stater I ZIP: q'7ex'r Heat pump (site plan required)
L��� 6� I / a2 9 /'I InstalUreplacefurnace/burner BTU /H
Phone: Cif Fax: E -mail: Including ductwork /vent liner 0 Yes O No
CCB no.: /VII jp S ^� Install/replace /relocate heaters- suspended,
City /metro Iic. no.: e_ a-,2‘„ of { wall, or floor mounted
Name (please print): 'If' pyio , (U y pt _ , Vent for appliance other than furnace
CONTACT PERSON Refrigeration:
Absorption units BTU /H
Name: " ' bU Chillers HP
Address: (, f 5(,c> eQl tale: ^� t7�c Compressors HP
Environmental exhaust and ventilation:
City: I I ZIP: � s Ap
vent
Phone: ( o— t-ijQ IFax: ( I E -mail: Dryer exhaust
. ..,.v. :_._.. Ow , ?t ... ,
-.
Hoods, Type 1/ II /res. kitchen/hazmat
_ '" hood fire suppression system
t l Q
Name: ' Lt / 6 t d - r7 CSCt_ Exhaust fan with single duct (bath fans)
Mailing address: / 5,4 , //4 t w,, kik, Exhaust system apart from heating or AC
City: f f et ✓C( I State: (9y —jZIP: 7 -7 a ,- Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil,
Phone: _ , V Fax: E -mail: Fuel piping each additional over 4 outlets
ENGINEER Process p pmg (schematic required) •
Name: Number of outlets
Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: ZIP: Insert - type c`S i p ,oO
Phone: we , ' - .mail; Woodstove/pellet ove
Other:
Applicant's Applicant's s ture: �� n , � • Other:
Name (print ': nv. 1,4
'Not all jurisdictions accept credit cards, please call jurisdiction for more information Permit fee $
❑ Visa ❑MasterCard Notice: This permit application Minimum fee $ 2.--S°
Credit card number: / / expires if a permit is not obtained Plan review (at _ %) $ •
Expires within 180 days after it has been State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete.
. $
TOTAL $ 7
t
Cardholder signature Amount 440-4617 (6/00 /COM)
CIT ?OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Date Requested tJd - 3 AM PM BLD
Location f C 4 3 7 j (L staV c ( MEC ,-,?60/-- 603,71
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenan t!.i ELC
Retaining Wall - 7 ' ELR
Footing CC SS: /
Foundation FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab �� � YI SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
•
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
%MECHANICAL) = Post & Beam
Rough In Cl-)
Gas Line
Smo a Dampers
AS.,9 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 Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date /5 �� m Inspector E
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.