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Permit CITY OF TIGARD MECHANICAL PERMIT 1 1'� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00483 ��' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/11/2004 PARCEL: 2 S 111 AC -02700 SITE ADDRESS: 14650 SW 97TH AVE SUBDIVISION: TIGARDVILLE HEIGHTS ZONING: R -4.5 BLOCK: LOT: 037 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: El VENTS W/O APPL: VENT SYSTEMS: STORIES: 1 BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: ELE 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: 2 OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Install refrigeration for walk - in. $3900 valuation Owner: FEES TIGARD TUALATIN SCHOOL DISTRICT Description Date Amount 6960 SW SANDBURG ST [MECH] Permit Fee 8/11/200 $116.20 TIGARD, OR 97223 [MECPLN] Plan Rev 8/11/200 $29.05 [TAX] 8% State Surchart 8/11/200 $9.30 Phone: Total $154.55 Contractor: COMMERCIAL REFRIGERATION INC 5920 SE GLISAN STREET PORTLAND, OR 972133790 REQUIRED INSPECTIONS Phone: Cooling Unt Insp hone: 234 6445 Final Inspection Reg #: LIC 65271 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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -6699. Issu d By: . 1 • � �_ Permittee Signature: / Call (503) 639 -4175 by 7:00 P.M. for inspections nee. •ithe next business day / t sO 5w f- rte' ,, � o7� vl: 9/ -- -o / .S4 c a r Mechanical Permit Application Date received:7,94 a Y Permit no.: mP(��(� f 53 ``"'"�' City / .�,!�► ^:_„ y of Tigard g �� / P rojec U appl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd r W7 Date issued: By Receiptno.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 JUL 21 2 004 Case file no.: Payment type: Land use approval: a �� i Y OF T1G Building permit no.: TM OF PERMIT _ - . - - . _ ❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial ❑ Multi - family ❑ Tenant improvement 0 New construction ❑ Addition/alteration/replacement ❑ Other: JOB SITE INFORMATION . COMMERCIAL VALUATION SCHEDULE Job' address: 1 1---( G s S X 72 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 $ t 9,) D . Lot: (Block: (Subdivision: / *See checklist for important application information and Project name: T )A (, - /�-xc J. t(2 5 f/ L jurisdiction's fee schedule for residential permit fee. City /county: Tool A "A - I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE De cription and location of work on premises: `SST (— AND COMMERICAL/INDUSTRIAL EQUIPMENT SCHEDULE ci p at rl.1 - 00 eli g—) Ca fl Gf =Gt,) Fee (ea.) Total Est. date of completion/inspection: Description Qty. Res. only Res. onl Tenant improvement or change of use: HVAC: Is existing space heated or conditioned? ❑ Yes 0 No Air handling unit red) Is existing space insulated? 0 Yes 0 No Al conditioning e xi existing plan required) g p Alterati of existi HVAC system MECHANICAL CONTRACTOR Boiler /compressors Business name: L' ©1('t^ dot eatL' i/ /f.. ' C1e d 7 l /' ®, (, f State boiler permit no.: HP Tons BTU /H Address:S 92v IL) (j--e.t'SY'ou Fire/smoke dampers/duct smoke detectors City: 1/u I State ZIP: q 72../..3 Heat pump (site plan required) l k Phone :2_3C( -6 414/51 Fax 23C7 - c C6 ( E -mail: Install/replace furnace/burner BTU /H �' Including ductwork/vent liner ❑ Yes CI No CCB no.: , Install/replace/relocate heaters-suspended, City /metro lic. no.: wall, or floor mounted Name (please print): - rut_ c 0 , Vent for appliance other than furnace CONTACT PERSON Refri - ._ Absorption units BTU/H Name: c L S IN._ ado _e___ Chillers HP • Address: Compressors / HP Environmental exhaust and ventilation: City: I State: (ZIP: Appliance vent Phone: - Fax: E - mail: Dryer exhaust OWNER Hoods, Type U II/res. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct (bath fans) • Mailing address: Exhaust system apart from heating or AC City: (State: I ZIP: Fuel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: Fax: E -mail: Fuel piping each additional over 4 outlets ENGINEER Process piping (schematic required) • Name: • Number of outlets Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert - type Phone: ( Fax: E -mail: Woodstove/pellet stove Applicant's signature: /, c I Date: ? 2 ( i Other. Other: Name (print): d- . i lri,( /l c C ( /C M.ictt_ / Not all jurisdictions accept credit cards, please call jurisdiction for more information. Permit fee $ t0 ' 2- ❑ Visa 0 MasterCard Notice: This permit application Minimum fee $ Credit card number: / / expires if a permit is not obtained Plan review (at Z S %) $ L 9. 0.3 Expires within 180 days after it has been State surcharge (8 %) .... $ g 30 Name of cardholder as shown on credit card accepted as complete. TOTAL $ l S Cardholder signature Amount • 440 -4617 (6/00 /COM) CITY OF TIGARD 24 -Hour • BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST J BUP Received Date Requested ` AM PM BUP j�p� Location / 4/6 - 7 t / Suite MEC .X©# 0 d 7 Contact Person Ph ( ) qg1 _0337 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner Uat / _ ELC Footing 4 ELC Foundation 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: Final PASS PLUMBING FAIL , , Post &Beam Under Slab Slab •_ Rough -In W Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke.Dampers ( PART FAIL E ` RICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ require.. befo e next.inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE ❑ Please call • r reinsp- tion RE: \ :_" Unable to inspect — no access A ire Supply Line _ DA Approach/Sidewalk Date I nspector ' _� Ext Other: Final DO NOT REMOVE this Inspection record from the job site. PASS PART FAIL