Permit A CITY OF TIGARD MECHANICAL PERMIT
J 1
i DEVELOPMENT SERVICES PERMIT #: MEC2002 -00073
��" ` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/2/02
PARCEL: 2S1 14A0 -01500
SITE ADDRESS: 17005 SW 92ND AVENUE
SUBDIVISION: ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS: 2
STORIES: 1 BOILERS /COMPRESSORS HOODS: 1
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
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks: Restroom with concession - Phase II of Cook Park Master Plan expansion.
Owner: FEES
TIGARD, CITY OF Type By Date Amount Receipt
13125 SW HALL
TIGARD, OR 97223
Total
Phone:
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 692 -1565 Shaft Inspection
Reg #: LIC 5193 Hood Inspection
Fire Suppr Insp
Final Inspection
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 -e:: 6. You may obtain copies of these rules or direct questions to OUNC by calling
( -Q1RQ
Issue B L ,_' . I ' i i Permittee Signature: ; ; i�--�—
Call (503 639 -4175 by 7:00 P.M. for inspections needed the next business day
----- Es - r - iLoc, H 1,07et),JCts/e/...)
,.. Mechani Permit Application ` � " � '
Date received: #" d2 Permit no.: rife -, 73
5t' l li City of Tigard ty b Project/appl. no.: Ex d
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: I . M Receiptno.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: 1U o ZOCi) " 00001 Building permit no.:
r . _ - ' . .TYPE OF PERMIT ' ' -
❑ I & 2 family dwelling or accessory ❑ Commercial /industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
T •'JOB SITE INFORMATIONS COMMERCIAL VALUATION - SCHEDULE ; =
Job address: 1 906_' 3 L.3 `302 'uC . Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ .
Lot: (Block: ISubdivi /sion: J� *See checklist for important application information and
Project name: _
C.z,,KPA - 456 p/ � j��" iC !/"� jurisdiction's fee schedule for residential permit fee.
City /county: ri+ /I Loc , ZIP: G� 7 1 8 : 2 FAMILY PERMIT FEE 3
Description and ation tf�''o on rer s: \ AND COMMERICAL/INDUSTRIAL EQUIPMENTSCHEDULE
G✓T`�XJWCp� /d / Fee(ea.) Total
Est. date of completion/inspection: Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Air handling unit CFM
Is existing space heated or conditioned? ❑ Yes ❑ No Air conditioning (site plan required)
Is existing space insulated? ❑ Yes ❑ No Alteration of existing HVAC system
.MECHANICAL CONTRACTOR ' • Boiler /compressors
State boiler permit no.:
. HP Tons BTU /H
ARROW MECHANICAL Fire /smoke dampers /duct smoke detectors
/
10330 SW TUALATIN RD Heat pump (site plan required)
'
I \ Install/replace furnace/burner BTU /H
TUALATIN OR 97062 • Including ductwork/vent liner ❑ Yes ❑ No
PH: 503- 692 -1565 CCB #: 5193 . Instal /replace /relocate heaters - suspended,
wall, or floor mounted
Name (please print): Vent for appliance other than furnace
' •CONTACT PERSON • • ' Refrigeration:
., ,; Absorpt un BTU /H
Name: Chillers HP
Compressors HP
Address:
Environmental exhaust and ventilation:
City: ' I State: I ZIP: Appliance vent
Phone: Fax: - E -mail: Dryer exhaust
OWNER ' : . - ' Hoods, 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
ZIP: Fuel piping and distribution (up to 4 outlets)
State:
City: I I Type: LPG NG Oil
Phone: Fax: E -mail: Fuel pi ip ng_each additional over 4 outlets
Process pipmg (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert - type
Phone: F� E -mail: Other:
Permit ' Applicant's signature: 'i I Date: - / / -/
& _ Other:
Name (print): , 4, / t
Not all jurisdictions accept credit c.. , please callurisdiction for more information Permit fee $ —
❑ Visa ❑ MasterCard Notice: This permit application Minimum fee $
expires if a permit is not obtained Plan review (at %) $
Credit card Dumber: Ex
Expires wit hin 180 days after it has been
p State surcharge (8 %) .... $
Name of cardholder as shown on credit card accepted as complete. TOTAL $
Cardholder signature Amount , 440 -4617 (6/00 /COM)
..
CITY OF TIGARD jns Line: 503 639 - 4175 —00
BUILDING ( )
INSPECTION DIVISION r ' Business Line: (503) 639 -4171
•
•
• • PbD` — D60 �oZ
Received Date Requested lb � G 7 AM PM BUP
d
Location (7 on 5 % IUD Suite =' — 60 7 3
Contact Person Ph ( ) (0 9 ' l S (o S PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner �� ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof Other:
�
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain n V/
Shower Pan /� \
JP )
Other: o V
Final /
PASS PART FAIL fi,
MECHANICAL
Post & Beam ,t
-o - n N.H\ V Gas Line , dV Smoke Dampers
SS ART FAIL
PA RICAL '"'L
Service jJ
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final fl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect – no access
Fire Supply Line 1
ADA
Approach/Sidewalk Date , / O '2 — Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL